1285705616 NPI number — KARIN GILLESPIE WEBER L.C.P.C.

Table of content: KARIN GILLESPIE WEBER L.C.P.C. (NPI 1285705616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285705616 NPI number — KARIN GILLESPIE WEBER L.C.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEBER
Provider First Name:
KARIN
Provider Middle Name:
GILLESPIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.C.P.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285705616
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3724 CARDIFF RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHEVY CHASE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20815-5944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-951-9594
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10914 GEORGIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHEATON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20902-4722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-681-3201
Provider Business Practice Location Address Fax Number:
301-681-8862
Provider Enumeration Date:
11/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  0094 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: 80000101 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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