Provider Demographics
NPI:1831147065
Name:WEBER, JOSHUA D (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 411895
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1895
Mailing Address - Country:US
Mailing Address - Phone:913-632-2230
Mailing Address - Fax:913-632-2297
Practice Address - Street 1:9100 W 74TH ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-4004
Practice Address - Country:US
Practice Address - Phone:913-676-2679
Practice Address - Fax:913-789-7191
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0431841207L00000X
MO2022001205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200402520AMedicaid
KSP00355790OtherRR MEDICARE
MO201731304Medicaid
MO201731304Medicaid