Provider Demographics
NPI:1043311350
Name:WEAVER, DONALD J (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:WEAVER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 GLEN COVE DR
Mailing Address - Street 2:STE 104
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4235
Mailing Address - Country:US
Mailing Address - Phone:207-594-7705
Mailing Address - Fax:207-594-0543
Practice Address - Street 1:4 GLEN COVE DR
Practice Address - Street 2:STE 104
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4235
Practice Address - Country:US
Practice Address - Phone:207-594-7705
Practice Address - Fax:207-594-0543
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME007465207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME141950Medicare ID - Type UnspecifiedMEDICARE
MED03572Medicare UPIN