Organization
PRINCE SQUIRE MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER WEAVER SQUIRE MD (VICE PRESIDENT)
(434) 634-4148
Entity
Organization
Contact information
Practice address
219 WEAVER AVENUE, EMPORIA, VA 23847
(434) 634-4148
(434) 634-6963
Mailing address
219 WEAVER AVENUE, EMPORIA, VA 23847
(434) 634-4148
(434) 634-6963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903779
—
NC
Enumeration date
07/27/2006
Last updated
08/22/2020
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