Provider Information for 1124613708
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Mrs. SHAY MARIE WEAVER LRIC
Sex: Female
NPI: 1124613708
Last Updated: 2021-03-04
Certification Date: 2021-02-26
Certification Date: 2021-02-26
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1124613708 | ||||||||
| Enumeration Date | 2021-03-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 745 ABBEY DR VIRGINIA BEACH, VA 23455-6530 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 505 S INDEPENDENCE BLVD STE 213 VIRGINIA BEACH, VA 23452-1150 United States Phone: 757-376-8167 | Fax: | ||||||||
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