Provider Demographics
NPI:1295169738
Name:WEBER, PAUL FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FREDERICK
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 1:9 BAY ST
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-1705
Mailing Address - Country:US
Mailing Address - Phone:732-758-9315
Mailing Address - Fax:
Practice Address - Street 1:9 BAY ST
Practice Address - Street 2:
Practice Address - City:RUMSON
Practice Address - State:NJ
Practice Address - Zip Code:07760-1705
Practice Address - Country:US
Practice Address - Phone:732-758-9315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-31
Last Update Date:2013-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05203600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine