| Doctor Name: | RYAN WEAVER |
| NPI Number: | 1144363912 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | VAD000 |
| Business Practice Address: | 1 Munro Ave Cape May, NJ - 082045000 |
| Business Phone Number: | 4109371462 |
| Business Fax Number: | |
| Mailing Address: | 1281 Wilson Dr, CAPE MAY |
| State: | NJ |
| Postal Code: | 082045269 |
| Phone Number: | 6098986610 |
| Fax Number: | 6098986962 |
| NPI Enumeration Date: | 02/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | VAD000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |