Individual
MARVIN V WEAVER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8888 SUMMA AVE, CARDIOLOGY TOWER 3RD FLOOR, BATON ROUGE, LA 70809-3720
(225) 769-4493
(225) 766-3144
Mailing address
8888 SUMMA AVE, CARDIOLOGY TOWER 3RD FLOOR, BATON ROUGE, LA 70809-3720
(225) 769-4493
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
207675
LA
2086S0129X
Vascular Surgery Physician
269236
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2387405
—
LA
Enumeration date
04/20/2010
Last updated
01/07/2016
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