| Leon D Weaver, MD | |
| 
					1161 Omega Dr, Hagerstown, MD 21740-5574  | |
| (301) 393-2600 | |
| (301) 393-2614 | 
| Full Name | Leon D Weaver | 
|---|---|
| Gender | Male | 
| Speciality | Pediatrics - Adolescent Medicine | 
| Location | 1161 Omega Dr, Hagerstown, Maryland | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1255323119 | NPI | - | NPPES | 
| 982000100 | Medicaid | MD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2080A0000X | Pediatrics - Adolescent Medicine | D57280 (Maryland) | Primary | 
| 208000000X | Pediatrics | D57280 (Maryland) | Secondary | 
| Entity Name | Medical Practices Of Antietam, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1558430843 PECOS PAC ID: 2567353865 Enrollment ID: O20040324001019  | 
| Entity Name | Privia Medical Group Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1013042480 PECOS PAC ID: 4385682061 Enrollment ID: O20140522000040  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Leon D Weaver, MD 1161 Omega Dr, Hagerstown, MD 21740-5574 Ph: (301) 393-2600  | Leon D Weaver, MD 1161 Omega Dr, Hagerstown, MD 21740-5574 Ph: (301) 393-2600  | 
Dr. Albert John Strauss Jr., MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 319 E Antietam St, Hagerstown, MD 21740 Phone: 301-790-3620 Fax: 301-797-2863  | |
Dr. Naheed F Saif, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 330 Mill St, Hagerstown, MD 21740 Phone: 240-420-0333 Fax: 240-420-0113  | |
Dr. Bruce Edward Weneck, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 303 Memorial Blvd W, Hagerstown, MD 21740 Phone: 301-791-7060 Fax: 301-791-8990  | |
Dr. Paul Joseph Andrew Hennis, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 201 S Cleveland Ave, Hagerstown, MD 21740 Phone: 301-745-3777  | |
Chukwuemeka Obidi, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 303 Memorial Blvd W, Hagerstown, MD 21740 Phone: 301-791-7060 Fax: 301-791-8990  | |
Dr. Atchuthanand Budi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1141 Opal Court, Hagerstown, MD 21740 Phone: 301-791-6666 Fax: 301-791-4549  |