Individual
DR. CHARLES EDWARD WEAVER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
470 NORTHSIDE CHEROKEE BLVD STE 170, CANTON, GA 30115-8029
(770) 721-9540
(770) 721-9541
Mailing address
2500 HOSPITAL BLVD, STE 310, ROSWELL, GA 30076-4947
(770) 664-9600
(770) 664-9856
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
56242
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
642893452A
—
GA
01
—
854350
BCBS OF GA
—
Enumeration date
05/25/2005
Last updated
02/26/2021
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