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CLARE D WEIDMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
JACKSON RIVER ORTHOPEDICS, 1 ARH LANE, STE 102, LOW MOOR, VA 24457
(540) 862-6777
(540) 863-9167
Mailing address
PO BOX 457, 5 E ALVON ROAD, SUITE 7, WHITE SULPHUR SPRINGS, WV 24986-2373
(304) 536-5030
(304) 536-5051

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101031888
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006404979
VA
05
0099154000
WV
01
200026
LUNG
01
258083
ANTHEM
VA
01
282196
ANTHEM
WV
01
4581381
AETNA
01
5191259
CCN
01
541839718
C&O
01
54183971800
WV WORKERS COMPENSATION
WV
01
541839718015
BS MOUNTAIN STATE
VA
01
541839718048
BS MOUNTAIN STATE
WV
01
58613
CARELINK
Enumeration date
06/16/2005
Last updated
10/15/2011
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