Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 0101223606 | VA |
Y | 207QS0010X | Family Doctor - Sports Medicine | O101223606 | VA |
NPI | 1295766525 |
---|---|
Provider Name | Thomas S. Weber |
First Address | Harrisonburg, VA 22803-1430 |
Second Address | Harrisonburg, VA 22801-8720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 24/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1295766525 | (05) | VA |