MEDICARE: THOMAS J 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	207R00000X	Internal Medicine Physician	0094-00169	NC
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	94-00169	NC

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	:	1659364750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS J WEBER MD

Provider Business Mailing Address
First Line	:	PO BOX 63362
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28263-3362
Country	:	US
Telephone Number	:	919-684-8111
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 DUKE MEDICINE CIR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27710-4000
Country	:	US
Telephone Number	:	919-668-1367
Fax Number	:	919-668-1366

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/02/2013

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