Individual
BRENDON J WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7185 BERNVILLE RD, SUITE B, BERNVILLE, PA 19506-8624
(610) 488-5315
(610) 488-5296
Mailing address
7185 BERNVILLE RD, SUITE B, BERNVILLE, PA 19506-8624
(610) 488-5315
(610) 488-5296
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001233
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG001233
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009637000001
—
PA
01
—
1598378
HIGHMARK BLUE SHIELD
PA
01
—
2277395000
INDEPENDENCE BLUE CROSS
—
01
—
2397071
UNITED HEALTHCARE
PA
01
—
50053706
CAPITAL BLUE CROSS
PA
01
—
7964550
AETNA
PA
Enumeration date
04/03/2006
Last updated
06/06/2011
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