Provider Demographics
NPI:1720094824
Name:WEBER, STEVE W (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:W
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 1:160 HERITAGE WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-752-8825
Mailing Address - Fax:406-257-5554
Practice Address - Street 1:160 HERITAGE WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3161
Practice Address - Country:US
Practice Address - Phone:406-752-8825
Practice Address - Fax:406-257-5554
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4043207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0023244Medicaid
MTD96158Medicare UPIN
MT000001007Medicare ID - Type Unspecified