Healthcare Provider Details

I. General information

NPI: 1861564056
Provider Name (Legal Business Name): CYNTHIA ANN WEYMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 01/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 ALEXANDER ST
FAYETTEVILLE NC
28301-5752
US

IV. Provider business mailing address

946 JOHN B CARTER RD
FAYETTEVILLE NC
28312-6953
US

V. Phone/Fax

Practice location:
  • Phone: 910-920-3838
  • Fax:
Mailing address:
  • Phone: 910-483-4747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number5960
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: