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Individual

DR. EDGAR N WEAVER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5304 INDIAN GRAVE RD SW, SUITE A, ROANOKE, VA 24018-9108
(540) 772-7107
(540) 772-7858
Mailing address
1234 FRANKLIN RD SW, ROANOKE, VA 24016-4606
(540) 772-7107
(540) 772-7858

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101033189
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006196705
VA
01
140001855
RAILROAD MEDICARE
01
C01334
MEDICARE LEGACY GROUP NUM
VA
01
C12923
RAILROAD MEDICARE LEGACY
Enumeration date
08/11/2006
Last updated
05/17/2010
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