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General NPI Number Information
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NPI Number | 1619933280
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Entity Type | Individual
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Provider Name | SAMUEL L. WEIR O.D.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2006
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Last Update Date | 05/02/2012
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Provider Practice Location Address
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Address Line | 528 WATERLOO RD
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City | WARRENTON
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State | VA
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Zip | 20186-3011
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Country | US
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Telephone | 540-347-0555
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Fax | 540-347-9198
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Provider Business Mailing Address
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Address Line | 5844 UNIVERSITY CT
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City | WARRENTON
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State | VA
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Zip | 20187-9329
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Country | US
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Telephone | 540-347-0555
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Fax | 540-347-9198
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000249
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License Number State | VA
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