Individual
WILLIAM LEE WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 N STATE ST, GREENFIELD, IN 46140-1270
(317) 802-6301
Mailing address
4012 HEYWARD PL, INDIANAPOLIS, IN 46250-4252
(317) 840-8547
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01050939
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000594485
BLUE SHIELD
IN
05
—
200244460
—
IN
Enumeration date
06/07/2006
Last updated
03/18/2009
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