Provider Demographics
NPI:1982675153
Name:WEBBER, SETH (MD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:WEBBER
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 1:1000 ROUTE 9 N
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1215
Mailing Address - Country:US
Mailing Address - Phone:732-634-0036
Mailing Address - Fax:732-634-9182
Practice Address - Street 1:1000 ROUTE 9 N
Practice Address - Street 2:SUITE 302
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1215
Practice Address - Country:US
Practice Address - Phone:732-634-0036
Practice Address - Fax:732-855-9395
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA69674207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8222606Medicaid
2232747OtherAETNA
NJ201805266AOtherHORIZON BLUE SHIELD
1479295OtherUNITED
2232747OtherAETNA
SW031787Medicare ID - Type Unspecified