Provider Demographics
NPI:1851786636
Name:WEBER, ANDREW TODD (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:TODD
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST.
Mailing Address - Street 2:3 DULLES BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-349-8222
Mailing Address - Fax:215-349-5915
Practice Address - Street 1:3400 SPRUCE ST.
Practice Address - Street 2:3 DULLES BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4206
Practice Address - Country:US
Practice Address - Phone:215-349-8222
Practice Address - Fax:215-349-5915
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD477534207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine