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General NPI Number Information
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NPI Number | 1982674859
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Entity Type | Organization
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Legal Business Name | WEAVERVILLE FAMILY MEDICINE ASSOCIATES, PA
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 63 MONTICELLO RD
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City | WEAVERVILLE
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State | NC
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Zip | 28787-9441
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Country | US
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Telephone | 828-645-3066
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Fax | 828-658-1445
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Provider Business Mailing Address
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Address Line | PO BOX 950
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City | WEAVERVILLE
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State | NC
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Zip | 28787-0950
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Country | US
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Telephone | 828-645-3066
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Fax | 828-658-1445
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | JANINE MAZUR
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Credential |
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Telephone | 828-645-3066
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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 | NC
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