1962406702 NPI number — DR. ASMA A WEBER MD

Table of content: DR. ASMA A WEBER MD (NPI 1962406702)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962406702 NPI number — DR. ASMA A WEBER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEBER
Provider First Name:
ASMA
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1962406702
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:
800 N 5TH AVE
Provider Second Line Business Mailing Address:
STE 101
Provider Business Mailing Address City Name:
SEQUIM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98382-3045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-582-2690
Provider Business Mailing Address Fax Number:
360-582-2691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 N 5TH AVE
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
SEQUIM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98382-3045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-582-2690
Provider Business Practice Location Address Fax Number:
360-582-2691
Provider Enumeration Date:
06/09/2005

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: 207Q00000X , with the licence number:  MD00040651 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0154786 . This is a "WA LABOR & INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 2165851 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8930469 . This is a "L& I CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8917WE . This is a "REGENCE BLUE CROSS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1115070 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 04358891798382A02 . This is a "TRICARE WPS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0801801336 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9113918 . This is a "CIGNA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 04358891701 . This is a "KITSAP PHYSICIAN SERVICES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 5422713 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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