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General NPI Number Information
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NPI Number | 1881665446
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Entity Type | Individual
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Provider Name | GREGORY B WEBSTER MD
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Gender | Male
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 8450 SEASONS PKWY
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City | WOODBURY
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State | MN
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Zip | 55125-4402
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Country | US
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Telephone | 651-702-5300
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Fax | 651-702-5305
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Provider Business Mailing Address
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Address Line | 8170 33RD AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55425-4516
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 42285
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 36759
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License Number State | MN
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