Provider Demographics
NPI:1093908311
Name:WEAVER-LEE, LASHAWN ANTOINETTE
Entity type:Individual
Prefix:DR
First Name:LASHAWN
Middle Name:ANTOINETTE
Last Name:WEAVER-LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 BLACKWATER DR
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9920
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1381 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-5130
Practice Address - Country:US
Practice Address - Phone:252-536-5800
Practice Address - Fax:252-519-0655
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC92569207V00000X
NC2008-01033207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology