Provider Demographics
NPI:1093713588
Name:WEBER, ROBERT B (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:WEBER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2034
Mailing Address - Country:US
Mailing Address - Phone:610-489-2533
Mailing Address - Fax:610-489-2532
Practice Address - Street 1:123 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TRAPPE
Practice Address - State:PA
Practice Address - Zip Code:19426-2034
Practice Address - Country:US
Practice Address - Phone:610-489-2533
Practice Address - Fax:610-489-2532
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001363L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
072137ZF2AMedicare PIN
PAT27181Medicare UPIN
PA0734870001Medicare NSC