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NPI Code Detail

MEDICARE: DR. ANDREA LYNN WEBER M.D.

MEDICARE: DR. ANDREA LYNN WEBER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician39478CO

General Provider Information

NPI Number : 1003810482
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA LYNN WEBER M.D.
Provider Business Mailing Address
First Line : 26659 PLEASANT PARK RD
Second Line :
City : CONIFER
State : CO
Zip : 80433-7714
Country : US
Telephone Number : 303-647-5300
Fax Number :
Provider Business Practice Location Address
First Line : 26659 PLEASANT PARK RD
Second Line :
City : CONIFER
State : CO
Zip : 80433-7714
Country : US
Telephone Number : 303-647-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 07/06/2015

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