Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | DR-50351 | CO |
N | 207YS0123X | Facial Plastic Surgeon | DR-50351 | CO |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | DR-50351 | CO |
NPI | 1366634388 |
---|---|
Provider Name | Dr. Stephen Weber |
First Address | Lone Tree, CO 80124-2888 |
Second Address | Lone Tree, CO 80124-2888 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2007 |
Last Update Date | 04/02/2014 |