Provider Demographics
NPI:1891744579
Name:WEBER, CHRISTOFFER J (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOFFER
Middle Name:J
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 STATE HIGHWAY 248
Mailing Address - Street 2:SUITE 3, CHRIS WEBER, MD
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-7740
Mailing Address - Country:US
Mailing Address - Phone:417-337-5500
Mailing Address - Fax:417-337-5568
Practice Address - Street 1:574 STATE HIGHWAY 248
Practice Address - Street 2:SUITE 3, CHRIS WEBER, MD
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-7740
Practice Address - Country:US
Practice Address - Phone:417-337-5500
Practice Address - Fax:417-337-5568
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO118855174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204015713Medicaid