Individual
CRAIG E WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
1101 TWIN C LN, SUITE 101, NEWARK, DE 19713-2157
(302) 633-1280
(302) 633-1284
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(803) 812-3656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J10001409
DE
225100000X
Physical Therapist
PT008320L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0452012000
AMERIHEALTH/IBC
PA
01
—
0452012000
AMERIHEALTH IBC
—
05
—
1000037865
—
DE
01
—
1744466581
CHAMPUS
—
01
—
428833
PA BS
PA
01
—
5070-0019
CARE FIRST
—
01
—
61926301
NCA
—
01
—
880770
CAREFIRST
PA
01
—
880770
PABS
—
01
—
J10001409
DE LICENSE
DE
01
—
PT008320L
PA LICENSE
PA
Enumeration date
06/22/2006
Last updated
12/30/2024
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