MEDICARE: AMANDA MARIE WEBBER PA-C

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	363A00000X	Physician Assistant	003347	OH

General Provider Information

NPI Number	:	1073888749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE WEBBER PA-C

Provider Business Mailing Address
First Line	:	5400 FRANTZ RD
Second Line	:	SUITE 250
City	:	DUBLIN
State	:	OH
Zip	:	43016-4144
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 WELCOME PL
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-7813
Country	:	US
Telephone Number	:	614-533-6800
Fax Number	:	614-338-8735

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

Provider Enumeration Date	:	03/14/2012
Last Update Date	:	12/31/2015

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