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NPI Code Detail

MEDICARE: GLOECKNER WEBER, LLC

MEDICARE: GLOECKNER WEBER, LLC
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1013158849
Entity Type Code : Organization
Provider Name (Legal Business Name) : GLOECKNER WEBER, LLC
Provider Business Mailing Address
First Line : 517 PARK ST
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22902-4739
Country : US
Telephone Number : 434-970-1904
Fax Number : 434-970-2044
Provider Business Practice Location Address
First Line : 517 PARK ST
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22902-4739
Country : US
Telephone Number : 434-970-1904
Fax Number : 434-970-2044
Authorized Official
Title or Position : OWNER
Name : MR. BRIAN WEBER
Credential :
Telephone Number : 434-760-3259
Provider Enumeration Date : 03/06/2009
Last Update Date : 03/06/2009

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Directions to “GLOECKNER WEBER, LLC ” Practice Location

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