Individual
TERRY DEAN WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
602 1ST ST NE STE 1, WESSINGTON SPRINGS, SD 57382-2163
(605) 539-1778
Mailing address
602 1ST ST NE STE 1, WESSINGTON SPRINGS, SD 57382-2163
(605) 539-1778
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
E-3438
AR
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
E-3438
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD2018-0286
NMMB LICENSE
NM
Enumeration date
06/14/2005
Last updated
03/10/2020
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