Provider Demographics
NPI:1366634388
Name:WEBER, STEPHEN (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9695 S YOSEMITE ST
Mailing Address - Street 2:SUITE 359
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2888
Mailing Address - Country:US
Mailing Address - Phone:303-792-2224
Mailing Address - Fax:888-378-4980
Practice Address - Street 1:9695 S YOSEMITE ST
Practice Address - Street 2:SUITE 359
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2888
Practice Address - Country:US
Practice Address - Phone:303-792-2224
Practice Address - Fax:888-378-4980
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR-50351207Y00000X, 207YS0123X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery