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General NPI Number Information
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NPI Number | 1205497385
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Entity Type | Individual
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Provider Name | ADAM JAMES WEAVER DO
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Gender | Male
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Dates
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Enumeration Date | 06/27/2019
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 18 E LAUREL RD
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City | STRATFORD
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State | NJ
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Zip | 08084-1327
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Country | US
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Telephone | 856-513-4124
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Fax |
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Provider Business Mailing Address
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Address Line | 22 JAMIE DR
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City | SEWELL
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State | NJ
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Zip | 08080-3532
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MB11513300
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License Number State | NJ
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