Healthcare Provider Details

I. General information

NPI: 1083848097
Provider Name (Legal Business Name): GRETCHEN LAYNE WEBER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2009
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2916 VANGADER DRIVE
ZANESVILLE OH
43701
US

IV. Provider business mailing address

2916 VANGADER DRIVE
ZANESVILLE OH
43701
US

V. Phone/Fax

Practice location:
  • Phone: 740-453-0661
  • Fax: 740-453-4940
Mailing address:
  • Phone: 740-453-0661
  • Fax: 740-453-4940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC7-0004230
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35.127650
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: