MEDICARE: DAVID CLINTON WEIBEL MD

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	208800000X	Urology Physician	MD026433L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245216001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CLINTON WEIBEL MD

Provider Business Mailing Address
First Line	:	5 ATRIUM CT
Second Line	:
City	:	SELINSGROVE
State	:	PA
Zip	:	17870-9017
Country	:	US
Telephone Number	:	570-372-9933
Fax Number	:	570-372-0828

Provider Business Practice Location Address
First Line	:	3 HOSPITAL DR
Second Line	:	SUITE 306
City	:	LEWISBURG
State	:	PA
Zip	:	17837-9362
Country	:	US
Telephone Number	:	570-523-3900
Fax Number	:	570-523-3834

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	07/08/2007

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