# KEVIN J WEBER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386626562
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 196960 | CA | Yes |
| 207X00000X | Orthopaedic Surgery Physician | 28989 | WI | — |

## Other

- **Enumeration date:** 11/15/2005
- **Last updated:** 10/18/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000257010 | MEDICARE PROVIDER ID NUMBER | WI |
| 01 | — | 0676320001 | MEDICARE DME | WI |
| 01 | — | 1386626562 | PHYSICIANS PLUS | WI |
| 01 | — | 16008 | DEAN HEALTH INSURANCE | WI |
| 05 | — | 31575100 | — | WI |
| 01 | — | 504547638 | TRICARE | WI |
| 01 | — | W010562 | CHAMPUS | — |