Individual
KATRINA LEE WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4348 ELECTRIC RD, ROANOKE, VA 24018-0720
(540) 769-0976
(540) 857-5383
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5352
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101278072
VA
208600000X
Surgery Physician
MD.32264
AL
2086S0102X
Surgical Critical Care Physician
2015020981
MO
2086S0120X
Pediatric Surgery Physician
MD.32264
AL
2086S0120X
Pediatric Surgery Physician
MED-PHYS-LIC-123987
MT
Other
Enumeration date
07/22/2009
Last updated
02/19/2024
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