Individual
EDWARD CHAS WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7631 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-7770
(260) 436-3570
Mailing address
7631 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-7770
(260) 436-3570
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
02000671
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100328200
—
IN
Enumeration date
11/22/2005
Last updated
10/02/2007
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