Doctor Name: | MR. FREDERICK JOSEPH WEBER |
NPI Number: | 1023106200 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | MA001036L |
Business Practice Address: | 746 Jefferson Ave Scranton, PA - 185101624 |
Business Phone Number: | 5703487100 |
Business Fax Number: | 5703487696 |
Mailing Address: | 746 Jefferson Ave, SCRANTON |
State: | PA |
Postal Code: | 185101624 |
Phone Number: | 5703487100 |
Fax Number: | 5703487696 |
NPI Enumeration Date: | 10/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | MA001036L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |