Provider Demographics
NPI:1285618918
Name:WEAVER, JOHN P (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:WEAVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BERNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9453
Mailing Address - Country:US
Mailing Address - Phone:610-378-2000
Mailing Address - Fax:610-378-2799
Practice Address - Street 1:2494 BERNVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9467
Practice Address - Country:US
Practice Address - Phone:610-378-2557
Practice Address - Fax:610-208-8839
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76211207T00000X
PAMD465745207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110051598AMedicaid
MAF31626Medicare UPIN
MAJ1270501Medicare PIN