MEDICARE: DR. MICHAEL D WEBER D.C., ART

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	111N00000X	Chiropractor	747	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0080142	OTHER	SD	BLUE CROSS BS / WELLMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912953282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL D WEBER D.C., ART

Provider Business Mailing Address
First Line	:	1230 NORTH AVE STE 7
Second Line	:
City	:	SPEARFISH
State	:	SD
Zip	:	57783-1572
Country	:	US
Telephone Number	:	605-642-1000
Fax Number	:	605-642-1100

Provider Business Practice Location Address
First Line	:	1230 NORTH AVE STE 7
Second Line	:
City	:	SPEARFISH
State	:	SD
Zip	:	57783-1572
Country	:	US
Telephone Number	:	605-642-1000
Fax Number	:	605-642-1100

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	10/28/2009

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