Provider Demographics
NPI:1144283037
Name:WEBER, DAVID R (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
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 1:5200 CENTRE AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1300
Mailing Address - Country:US
Mailing Address - Phone:412-664-2782
Mailing Address - Fax:
Practice Address - Street 1:5200 CENTRE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1300
Practice Address - Country:US
Practice Address - Phone:412-664-2782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028852E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00241663OtherRAILROAD MEDICARE
PA148325OtherHIGHMARK BLUE SHIELD
100744OtherUPMC HEALTH PLAN
PA0012121230005Medicaid
1037472OtherGATEWAY HEALTH PLAN
PA148325OtherHIGHMARK BLUE SHIELD
P00241663OtherRAILROAD MEDICARE