Individual
BRYAN DOUGLAS WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS,MD
Contact information
Practice address
1 MED CENTER DRIVE, MORGANTOWN, WV 26506
(304) 293-2240
Mailing address
1 MED CENTER DRIVE, MORGANTOWN, WV 26506
(304) 293-2240
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1821
WV
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2676
WV
Other
Enumeration date
10/20/2006
Last updated
06/28/2016
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