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Contact Information

CHARLES E WEAVER JR, MD PHD
470 NORTHSIDE CHEROKEE BLVD STE 170
CANTON, GA30115-8029
 Phone: 770-721-9540
 Fax: 770-721-9541
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for CHARLES E WEAVER JR · (Male)

NPI # 1801899554
Status Active
Credentials MD PHD
Entity Individual
Enumeration date 05/25/2005
Last updated 02/26/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 56242
  • GA Medicaid 642893452A
  • Other 854350 BCBS OF GA
Hospital affiliation(s)
  • NORTHSIDE HOSPITAL - (Acute Care)
    1000 JOHNSON FERRY ROAD, NE
    ATLANTA, GA 30342
  • NORTHSIDE HOSPITAL CHEROKEE - (Acute Care)
    201 HOSPITAL ROAD
    CANTON, GA 30114
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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