Provider Demographics
NPI:1679580088
Name:WEAVER, MICHAEL LIVINGSTON (CPO CPED)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LIVINGSTON
Last Name:WEAVER
Suffix:
Gender:M
Credentials:CPO CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 NEW BERN AVE
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711
Mailing Address - Country:US
Mailing Address - Phone:828-669-8602
Mailing Address - Fax:828-299-5946
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:ASHEVILLE VAMC REHAB MED 117
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805
Practice Address - Country:US
Practice Address - Phone:828-299-2517
Practice Address - Fax:828-299-5946
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist