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NPI Code Detail

MEDICARE: GREGORY B WEBSTER MD

MEDICARE: GREGORY B WEBSTER 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
1207W00000XOphthalmology Physician42285WI
2207W00000XOphthalmology Physician36759MN

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 : 1881665446
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY B WEBSTER MD
Provider Business Mailing Address
First Line : 8170 33RD AVE S
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55425-4516
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8450 SEASONS PKWY
Second Line :
City : WOODBURY
State : MN
Zip : 55125-4402
Country : US
Telephone Number : 651-702-5300
Fax Number : 651-702-5305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 11/16/2021

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