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Individual

KEITH W WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
924 FULTON AVE SW, BIRMINGHAM, AL 35211-1229
(205) 786-0315
(205) 788-2663
Mailing address
924 FULTON AVE SW, BIRMINGHAM, AL 35211-1229
(205) 786-0315
(205) 788-2663

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
00009769
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000018378
AL
01
200004832
RAILROAD MEDICARE
AL
01
510-18378
BLUE CROSS OF ALABAMA
AL
Enumeration date
06/30/2006
Last updated
11/30/2010
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