Healthcare Provider Details

I. General information

NPI: 1750478640
Provider Name (Legal Business Name): LAWRENCE WN WEBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 LIBERTY AVE MELLON PAVILION SUITE 156-158
PITTSBURGH PA
15224-2156
US

IV. Provider business mailing address

2 ALLEGHENY CTR 6TH FLOOR
PITTSBURGH PA
15212-5402
US

V. Phone/Fax

Practice location:
  • Phone: 412-578-3503
  • Fax: 412-688-7760
Mailing address:
  • Phone: 412-330-5220
  • Fax: 412-330-5522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD019095E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: