Provider Demographics
NPI:1811030539
Name:DR. ROBERT B. WEBER, LTD.
Entity Type:Organization
Organization Name:DR. ROBERT B. WEBER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-489-2533
Mailing Address - Street 1:123 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2034
Mailing Address - Country:US
Mailing Address - Phone:610-489-2533
Mailing Address - Fax:610-489-2532
Practice Address - Street 1:123 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TRAPPE
Practice Address - State:PA
Practice Address - Zip Code:19426-2034
Practice Address - Country:US
Practice Address - Phone:610-489-2533
Practice Address - Fax:610-489-2532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001363L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005030910002Medicaid
173516Medicare PIN
PAT27181Medicare UPIN
0734870001Medicare NSC