MEDICARE: DR. RONALD S 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	207W00000X	Ophthalmology Physician	038125	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11898	OTHER	GA	COVENTRY PPO
2	0816347	OTHER	GA	UHC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5080141	OTHER	GA	AETNA
5	202226	OTHER	GA	COVENTRY HMO
6	52650070 013	OTHER	GA	BCBS

General Provider Information

NPI Number	:	1174520670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD S WEBER M.D.

Provider Business Mailing Address
First Line	:	1000 CORPORATE CENTER DR
Second Line	:	SUITE 100
City	:	MORROW
State	:	GA
Zip	:	30260-4180
Country	:	US
Telephone Number	:	770-968-8888
Fax Number	:	770-960-2473

Provider Business Practice Location Address
First Line	:	1000 CORPORATE CENTER DR
Second Line	:	SUITE 100
City	:	MORROW
State	:	GA
Zip	:	30260-4180
Country	:	US
Telephone Number	:	770-968-8888
Fax Number	:	770-960-2473

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	08/13/2009

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Directions to “ DR. RONALD S WEBER M.D.” Practice Location

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