Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 01365 | MD |
N | 222Z00000X | Podiatrist | 01365 | MD |
Y | 213ES0103X | Foot & Ankle Surgery | 01365 | MD |
NPI | 1063574515 |
---|---|
Provider Name | Jason Meade Weber |
First Address | Gaithersburg, MD 20877-2606 |
Second Address | Gaithersburg, MD 20877-2606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 07/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
409152300 | (05) | MD |
U80593 | (02) |