Organization
WEAVER NEUROSURGICAL SPINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR NEWMAN WEAVER JR. MD (PRESIDENT)
(540) 772-7107
Entity
Organization
Contact information
Practice address
5304 INDIAN GRAVE RD, SUITE A, ROANOKE, VA 24018-9100
(540) 772-7107
(540) 772-7858
Mailing address
5304 INDIAN GRAVE RD, SUITE A, ROANOKE, VA 24018-9100
(540) 772-7107
(540) 772-7858
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101033189
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6196705
—
VA
Enumeration date
05/18/2011
Last updated
05/18/2011
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