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NPI Code Detail

MEDICARE: PATRICK R WABER MD

MEDICARE:   PATRICK R WABER  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00034054WA
2207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianMD201549OR
3207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianMED-PHYS-LIC-131634MT

General Provider Information

NPI Number : 1225059439
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK R WABER MD
Provider Business Mailing Address
First Line : 2500 NE NEFF RD
Second Line :
City : BEND
State : OR
Zip : 97701-6015
Country : US
Telephone Number : 541-382-4321
Fax Number :
Provider Business Practice Location Address
First Line : 1100 HOLLENBECK LN
Second Line :
City : DEER LODGE
State : MT
Zip : 59722-2317
Country : US
Telephone Number : 406-846-1722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2006
Last Update Date : 03/08/2024

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