Provider Demographics
NPI:1447220645
Name:WEEBER, GEORGIA KIM (DPM)
Entity Type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:KIM
Last Name:WEEBER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:329 CONWAY ST
Mailing Address - Street 2:GREENFIELD HEALTH CENTER
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1521
Mailing Address - Country:US
Mailing Address - Phone:413-774-6301
Mailing Address - Fax:413-772-3314
Practice Address - Street 1:329 CONWAY ST
Practice Address - Street 2:GREENFIELD HEALTH CENTER
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1521
Practice Address - Country:US
Practice Address - Phone:413-774-6301
Practice Address - Fax:413-772-3314
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2163213E00000X, 213ES0131X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY75094OtherMEDICARE
MA3715511OtherAETNA
MAY75094OtherBLUE CROSS AND BLUE SHIEL
MA453533OtherTUFTS
MA333437OtherHARVARD PILGRIM HEALTH PL
MA28487OtherHEALTH NEW ENGLAND
MA756223OtherCONNECTICARE
MA4223254003OtherCIGNA
MA000000022096OtherBMC HEALTHNET
MAU09108Medicare UPIN