Provider Demographics
NPI:1477880029
Name:WEAVER, ANITHA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANITHA
Middle Name:
Last Name:WEAVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANITHA
Other - Middle Name:MARY
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 HIGHLANDS DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7693
Mailing Address - Country:US
Mailing Address - Phone:717-626-5437
Mailing Address - Fax:717-626-0875
Practice Address - Street 1:100 HIGHLANDS DR
Practice Address - Street 2:SUITE 204
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7693
Practice Address - Country:US
Practice Address - Phone:717-626-5437
Practice Address - Fax:717-626-0875
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441955208000000X
NJ25MD08583500208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics