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General NPI Number Information
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NPI Number | 1346251469
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Entity Type | Individual
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Provider Name | EDGAR N WEAVER JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 05/17/2010
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Provider Practice Location Address
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Address Line | 5304 INDIAN GRAVE RD SW SUITE A
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City | ROANOKE
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State | VA
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Zip | 24018-9108
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Country | US
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Telephone | 540-772-7107
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Fax | 540-772-7858
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Provider Business Mailing Address
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Address Line | 1234 FRANKLIN RD SW
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City | ROANOKE
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State | VA
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Zip | 24016-4606
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Country | US
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Telephone | 540-772-7107
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Fax | 540-772-7858
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 0101033189
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License Number State | VA
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