Weaver, Leroy D
Weaver, Leroy D is an individual health care provider with primary practice located at 620 W Edison Rd Ste 110, Mishawaka IN 46545-2784. He recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Therapeutic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Weaver, Leroy D can be contacted via phone (574) 258-1100.Contact Information
Primary practice address
620 W Edison Rd Ste 110
Mishawaka IN 46545-2784
Phone: (574) 258-1100
Fax: (574) 258-1101
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 01060476A | Indiana |
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | 01060476A | Indiana |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 01060476A | Indiana |
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | 01060476A | Indiana |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | 01060476A | Indiana |
| Allopathic & Osteopathic Physicians / Therapeutic Radiology | 2085R0203X | 01060476A | Indiana |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 01060476A | Indiana |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | 01060476A | Indiana |
Profile Details
| NPI number | 1710950258 |
|---|---|
| LBN Legal business name | Weaver, Leroy D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 7th, 2006 |
| Last updated | May 16th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710950258 | NPPES |
| Indiana | MEDICAID | 200809390 |
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