Individual
CRAIG E WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
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
Update your record
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