MEDICARE: PROF. STEVEN WEBER PHD

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	246Z00000X	Other Specialist/Technologist

General Provider Information

NPI Number	:	1770611741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. STEVEN WEBER PHD

Provider Business Mailing Address
First Line	:	305 KAREN CT
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-5026
Country	:	US
Telephone Number	:	608-263-7140
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 KAREN CT
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-5026
Country	:	US
Telephone Number	:	608-263-7140
Fax Number	:

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

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	07/08/2007

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