Healthcare Provider Details

I. General information

NPI: 1659735850
Provider Name (Legal Business Name): AARON MYERS WEAVER D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N. CLAYTON STREET
WILMINGTON DE
19805
US

IV. Provider business mailing address

PO BOX 824804
PHILADELPHIA PA
19182-4804
US

V. Phone/Fax

Practice location:
  • Phone: 302-575-8040
  • Fax:
Mailing address:
  • Phone: 302-334-0330
  • Fax: 302-330-0329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC2-0012947
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: