Healthcare Provider Details

I. General information

NPI: 1992797864
Provider Name (Legal Business Name): CARMEN WEEBER-MORSE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRIGHAM DR SUITE 200
PERRYSBURG OH
43551-7114
US

IV. Provider business mailing address

1601 BRIGHAM DR SUITE 200
PERRYSBURG OH
43551-7114
US

V. Phone/Fax

Practice location:
  • Phone: 419-872-7700
  • Fax: 419-874-0196
Mailing address:
  • Phone: 419-872-7700
  • Fax: 419-874-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35070932
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: