Provider Demographics
NPI:1861439630
Name:WEBER, JAMES A (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:WEBER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 SHADY TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-5209
Mailing Address - Country:US
Mailing Address - Phone:412-650-7399
Mailing Address - Fax:
Practice Address - Street 1:3036 SHADY TIMBER LN
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-5209
Practice Address - Country:US
Practice Address - Phone:412-650-7399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN-291759-L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015568980001Medicaid
PA050896Medicare ID - Type Unspecified
PA1015568980001Medicaid