Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 253255 | MA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 278034 | NY |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 35079500W | OH |
NPI | 1063477974 |
---|---|
Provider Name | Peter C Weber |
First Address | Boston, MA 02119-3791 |
Second Address | Boston, MA 02118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 03/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2249534 | (05) | OH |
F57647 | (02) | OH |