Individual
JOEL M WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PHD
Contact information
Practice address
410 WEST TENTH AVENUE, N429 DOAN HALL, COLUMBUS, OH 43210
(614) 293-8487
(614) 293-8153
Mailing address
410 W. TENTH AVE., N411 DOAN HALL, COLUMBUS, OH 43210-1250
(614) 293-8487
(614) 293-8153
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.014176
OH
207L00000X
Anesthesiology Physician
Primary
30014176
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0408624
—
OH
Enumeration date
05/01/2006
Last updated
12/11/2009
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