Provider Demographics
NPI:1881870277
Name:WEBER, JOSEPH TIMOTHY (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:TIMOTHY
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:414-328-8270
Mailing Address - Fax:414-328-8275
Practice Address - Street 1:2424 S 90TH ST FL 3
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2455
Practice Address - Country:US
Practice Address - Phone:414-328-8270
Practice Address - Fax:414-328-8275
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI55278207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100017232Medicaid
WI000973890Medicare UPIN