| Elizabeth M Weaver, M.d., P.l.c. | |
|
1031 Sterling Rd Suite 203 Herndon VA 20170-3865 | |
| (703) 466-5150 | |
| (703) 649-3557 |
| Full Name | Elizabeth M Weaver, M.d., P.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 1031 Sterling Rd, Herndon, Virginia |
| Authorized Official Name and Position | Elizabeth Mary Weaver (OWNER) |
| Authorized Official Contact | 7034665150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth M Weaver, M.d., P.l.c. 1031 Sterling Rd Suite 203 Herndon VA 20170-3865 Ph: (703) 466-5150 | Elizabeth M Weaver, M.d., P.l.c. 1031 Sterling Rd Suite 203 Herndon VA 20170-3865 Ph: (703) 466-5150 |
| NPI Number | 1336511971 |
|---|---|
| Provider Enumeration Date | 10/22/2015 |
| Last Update Date | 10/22/2015 |
| Medicare PECOS PAC ID | 9133439060 |
|---|---|
| Medicare Enrollment ID | O20151105001109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336511971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0101232754 (Virginia) | Primary |
| Provider Name | Elizabeth M Weaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689744252 PECOS PAC ID: 5698843324 Enrollment ID: I20081008000592 |
| Provider Name | Janice Z Speer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316295991 PECOS PAC ID: 7012137672 Enrollment ID: I20141002000086 |
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