Healthcare Provider Details

I. General information

NPI: 1659364750
Provider Name (Legal Business Name): THOMAS J WEBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR
DURHAM NC
27710-4000
US

IV. Provider business mailing address

PO BOX 63362
CHARLOTTE NC
28263-3362
US

V. Phone/Fax

Practice location:
  • Phone: 919-668-1367
  • Fax: 919-668-1366
Mailing address:
  • Phone: 919-684-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0094-00169
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number94-00169
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: