MEDICARE: DR. CARL G 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
1	207R00000X	Internal Medicine Physician	MD00040818	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
11	110242184	OTHER	WA	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6230157	OTHER	WA	CIGNA
2	7537336	OTHER	WA	AETNA US HEALTHCARE
3	1883652	OTHER	WA	UNITED HEALTHCARE
4	8931741	OTHER	WA	L&I CRIME VICTIMS
5	04358891702	OTHER	WA	KITSAP PHYSICIAN SERVICES
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	2146037	OTHER	WA	FIRST HEALTH
8	5422WE	OTHER	WA	REGENCE BLUE SHIELD
9	0159039	OTHER	WA	WA LABOR & INDUSTRIES
10	04358891798382A03	OTHER	WA	TRICARE WPS

General Provider Information

NPI Number	:	1073517827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL G WEBER M.D.

Provider Business Mailing Address
First Line	:	800 N 5TH AVE
Second Line	:	STE 101
City	:	SEQUIM
State	:	WA
Zip	:	98382-3045
Country	:	US
Telephone Number	:	360-582-2690
Fax Number	:	360-582-2691

Provider Business Practice Location Address
First Line	:	800 N 5TH AVE
Second Line	:	STE 101
City	:	SEQUIM
State	:	WA
Zip	:	98382-3045
Country	:	US
Telephone Number	:	360-582-2690
Fax Number	:	360-582-2691

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	05/16/2013

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