MEDICARE: MARC E WEBER 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	208000000X	Pediatrics Physician	28582	SC
2	208000000X	Pediatrics Physician	D70060	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	188569	OTHER	SC	MEDCOST
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4040854	OTHER	SC	AETNA

General Provider Information

NPI Number	:	1609830850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC E WEBER MD

Provider Business Mailing Address
First Line	:	PO BOX 6390
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-0390
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18045 GEORGIA AVE
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-2237
Country	:	US
Telephone Number	:	888-808-6483
Fax Number	:

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	10/21/2013

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Directions to “ MARC E WEBER MD” Practice Location

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