Provider Demographics
NPI:1033480322
Name:STEVEN A. WEBER M.D. INC.
Entity Type:Organization
Organization Name:STEVEN A. WEBER M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:317-736-8335
Mailing Address - Street 1:18 E STATE ROAD 44
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-7690
Mailing Address - Country:US
Mailing Address - Phone:317-736-8335
Mailing Address - Fax:317-736-7310
Practice Address - Street 1:18 E STATE ROAD 44
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-7690
Practice Address - Country:US
Practice Address - Phone:317-736-8335
Practice Address - Fax:317-736-7310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN50001782207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IND69620Medicare UPIN
IN431340Medicare PIN