Healthcare Provider Details

I. General information

NPI: 1568522399
Provider Name (Legal Business Name): THOMAS J WEBER JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 HEALTH PARK STE 309
RALEIGH NC
27615-4731
US

IV. Provider business mailing address

8300 HEALTH PARK STE 309
RALEIGH NC
27615-4731
US

V. Phone/Fax

Practice location:
  • Phone: 984-272-4028
  • Fax: 984-272-3917
Mailing address:
  • Phone: 984-272-4028
  • Fax: 984-272-3917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number200401449
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number200401449
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: