Provider Demographics
NPI:1689790578
Name:WEBB, ROXANA O (MD)
Entity Type:Individual
Prefix:DR
First Name:ROXANA
Middle Name:O
Last Name:WEBB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:209B W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-5443
Mailing Address - Country:US
Mailing Address - Phone:715-845-3637
Mailing Address - Fax:715-845-1977
Practice Address - Street 1:209B W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-5443
Practice Address - Country:US
Practice Address - Phone:715-845-3637
Practice Address - Fax:715-845-1977
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22862-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIB85213Medicare UPIN