Individual
DAVID L WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 J CLYDE MORRIS BLVD, RIVERSIDE REGIONAL MEDICAL CENTER, NEWPORT NEWS, VA 23601-1929
(757) 594-4405
(757) 594-3547
Mailing address
PO BOX 12087, NEWPORT NEWS, VA 23612-2087
(757) 867-6101
(757) 867-6587
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101034133
VA
2085R0202X
Diagnostic Radiology Physician
ME84643
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010264405
—
VA
05
—
1689655771
—
VA
01
—
17354
BCBS
FL
05
—
264087100
—
FL
01
—
P00468522
RAILROAD MEDICARE PIN
VA
Enumeration date
11/07/2005
Last updated
06/05/2008
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