MEDICARE: WEBSTER FAMILY PHYSICIANS, P.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	207Q00000X	Family Medicine Physician	36454	MO

General Provider Information

NPI Number	:	1235304494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEBSTER FAMILY PHYSICIANS, P.C.

Provider Business Mailing Address
First Line	:	7979 BIG BEND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63119-2703
Country	:	US
Telephone Number	:	314-961-6631
Fax Number	:	314-961-4796

Provider Business Practice Location Address
First Line	:	7979 BIG BEND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63119-2703
Country	:	US
Telephone Number	:	314-961-6631
Fax Number	:	314-961-4796

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTIAN WESSLING
Credential	:	M.D.
Telephone Number	:	314-961-6631

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	04/28/2008

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