Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 39782 | TN |
N | 207X00000X | Orthopaedic Surgeon | M9734 | TX |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 29484 | SC |
NPI | 1548380850 |
---|---|
Provider Name | Dr. Brian Alexander Weatherby |
First Address | Greenville, SC 29601-2842 |
Second Address | Simpsonville, SC 29681-3262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 18/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
294844 | (05) | SC |