Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 55805 | CO |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 55805 | CO |
NPI | 1205922655 |
---|---|
Provider Name | Ian C Weber |
First Address | Wheat Ridge, CO 80033-6028 |
Second Address | Westminster, CO 80023-9328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0902607 | MEDICA (01) | |
14073 | (05) | ND |
182H4WE | MN BCBS (01) | MN |
27952 | ND BCBS (01) | ND |
936485400 | (05) | MN |
I38908 | (02) |