Provider Demographics
NPI:1750478640
Name:WEBER, LAWRENCE WN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:WN
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 ALLEGHENY CTR
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5402
Mailing Address - Country:US
Mailing Address - Phone:412-330-5220
Mailing Address - Fax:412-330-5522
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:MELLON PAVILION SUITE 156-158
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-578-3503
Practice Address - Fax:412-688-7760
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD019095E207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014385320001Medicaid
PA0014385320001Medicaid
PA105677K62Medicare ID - Type Unspecified