Provider Demographics
NPI:1497137566
Name:WEAVER, VICTORIA BROOKE (DO)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:BROOKE
Last Name:WEAVER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:KU DEPARTMENT OF INTERNAL MEDICINE
Mailing Address - Street 2:3901 RAINBOW BLVD MS 2027
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-945-7072
Mailing Address - Fax:
Practice Address - Street 1:10787 NALL AVE STE 310
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1301
Practice Address - Country:US
Practice Address - Phone:913-945-6900
Practice Address - Fax:913-945-6970
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS94-08728207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine