Provider Demographics
NPI:1144213042
Name:WEBER, CHARLES ALFRED (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALFRED
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 HWY 138
Mailing Address - Street 2:STE 115
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9694
Mailing Address - Country:US
Mailing Address - Phone:732-988-5030
Mailing Address - Fax:732-988-5301
Practice Address - Street 1:3350 HWY 138
Practice Address - Street 2:STE 115
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-9694
Practice Address - Country:US
Practice Address - Phone:732-988-5030
Practice Address - Fax:732-988-5301
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04284800207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2282208Medicaid
NJ2282208Medicaid
NJ015246Medicare ID - Type Unspecified