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NPI Code Detail

MEDICARE: DR. MARK D WEBER M.D.

MEDICARE: DR. MARK D 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
1208100000XPhysical Medicine & Rehabilitation Physician11832MT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CA8374OTHERMDR/R MEDICARE GROUP #
3250011840OTHERMDR/R MEDICARE PROVIDER #

Other Identifiers

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

General Provider Information

NPI Number : 1346283702
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK D WEBER M.D.
Provider Business Mailing Address
First Line : 205 SUNNYVIEW LANE
Second Line :
City : KALISPELL
State : MT
Zip : 59901
Country : US
Telephone Number :
Fax Number : 410-601-8946
Provider Business Practice Location Address
First Line : 205 SUNNYVIEW LN
Second Line :
City : KALISPELL
State : MT
Zip : 59901-3120
Country : US
Telephone Number : 406-758-7035
Fax Number : 406-752-5210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 11/27/2023

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