Provider Demographics
NPI:1255690749
Name:WEAVER, DANIEL TIMOTHY (MB BCH BAO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:TIMOTHY
Last Name:WEAVER
Suffix:
Gender:M
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:UK DIV OF HOSPITAL MEDICINE
Mailing Address - Street 2:800 ROSE ST, MN604
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-6047
Mailing Address - Fax:859-257-3873
Practice Address - Street 1:UK DIV OF HOSPITAL MEDICINE
Practice Address - Street 2:800 ROSE ST, MN604
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-323-6047
Practice Address - Fax:859-257-3873
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY48071207R00000X, 207RA0401X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine