Provider Demographics
NPI:1225019466
Name:WEBBER, ANTHONY EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:EDWARD
Last Name:WEBBER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1153 CENTRE ST
Mailing Address - Street 2:STE 54
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3446
Mailing Address - Country:US
Mailing Address - Phone:617-522-1734
Mailing Address - Fax:617-522-8325
Practice Address - Street 1:1153 CENTRE ST
Practice Address - Street 2:STE 54
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-3446
Practice Address - Country:US
Practice Address - Phone:617-522-1734
Practice Address - Fax:617-522-8325
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2010-11-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD48454207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6176704Medicaid
MA700786OtherTUFTS
MAE05584OtherBCBS
MA700786OtherTUFTS
MAE05584OtherBCBS