MEDICARE: COLETTE S. WEBER D.P.M.

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	213ES0131X	Foot Surgery Podiatrist	000762	MO

General Provider Information

NPI Number	:	1306848007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLETTE S. WEBER D.P.M.

Provider Business Mailing Address
First Line	:	439 S KIRKWOOD RD
Second Line	:	STE. 208
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-6169
Country	:	US
Telephone Number	:	314-965-5371
Fax Number	:	314-965-2228

Provider Business Practice Location Address
First Line	:	439 S KIRKWOOD RD
Second Line	:	STE. 208
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-6169
Country	:	US
Telephone Number	:	314-965-5371
Fax Number	:	314-965-2228

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	01/28/2011

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1871760561 — COLETTE S. WEBER, D.P.M., LLC
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1417182817 — MRS. KELLY A HOLLANDER P.T.
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63122-6169

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1811222060 — DR. MARK XAVIER MCCARTHY DMD
Practice Location Address:

439 S KIRKWOOD RD , SUITE 201
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1538498225 — BARBARA JEAN MAGRUDER PT
Practice Location Address:

439 S KIRKWOOD RD
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63122-6169

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1518270792 — JEFFREY S. O'GUIN D.C., LLC
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439 S KIRKWOOD RD , SUITE 100
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