Provider Demographics
NPI:1124053988
Name:WEBSTER, WARREN R (MD)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:R
Last Name:WEBSTER
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 1:2727 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-2276
Mailing Address - Country:US
Mailing Address - Phone:513-321-0833
Mailing Address - Fax:513-321-6063
Practice Address - Street 1:2727 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-2276
Practice Address - Country:US
Practice Address - Phone:513-321-0833
Practice Address - Fax:513-321-6063
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35032691207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA76193Medicare UPIN
OHWE0435532Medicare ID - Type UnspecifiedMEDICARE ID #
OH110082215Medicare PIN