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General NPI Number Information
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NPI Number | 1538120191
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Entity Type | Organization
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Legal Business Name | ALBERT J WEAVER MD
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 14535 JOHN MARSHALL HWY SUITE 105
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City | GAINESVILLE
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State | VA
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Zip | 20155-4023
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Country | US
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Telephone | 703-754-4900
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Fax | 571-261-5235
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Provider Business Mailing Address
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Address Line | PO BOX 1256
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City | HAYMARKET
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State | VA
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Zip | 20168-8256
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Country | US
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Telephone | 703-754-4900
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Fax | 571-261-5235
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | ALBERT JUNIOR WEAVER
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Credential | MD
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Telephone | 703-754-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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