MEDICARE: DR. ANNE C WEAVER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	213299	MA
2	208000000X	Pediatrics Physician	213299	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	692597	OTHER	MD	HARVARD PILGRIM
3	213299	OTHER	MA	CONNECTICARE
4	213299	OTHER	MD	TUFTS
5	J24836	OTHER	MD	BLUE CROSS
6	30189	OTHER	MA	HEALTH NEW ENGLAND
7	2864065	OTHER	MD	AETNA

General Provider Information

NPI Number	:	1083612345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNE C WEAVER M.D.

Provider Business Mailing Address
First Line	:	29 COTTAGE ST
Second Line	:	SUITE C
City	:	AMHERST
State	:	MA
Zip	:	01002-2172
Country	:	US
Telephone Number	:	413-549-8888
Fax Number	:	413-549-8886

Provider Business Practice Location Address
First Line	:	29 COTTAGE ST
Second Line	:	SUITE C
City	:	AMHERST
State	:	MA
Zip	:	01002-2172
Country	:	US
Telephone Number	:	413-549-8888
Fax Number	:	413-549-8886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	08/27/2013

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Directions to “ DR. ANNE C WEAVER M.D.” Practice Location

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