Individual
MR. WILLIAM EDWARD WEBER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1455 W 2ND STREET, BLOOMINGTON, IN 47403
(812) 336-6060
(812) 333-7760
Mailing address
PO BOX 1148, BLOOMINGTON, IN 47402-1148
(812) 336-6060
(812) 333-7760
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
01027410A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091283
ANTHEM BLUE SHIELD
IN
05
—
100183060A
—
IN
01
—
240004398
MEDICARE RR
IN
Enumeration date
06/15/2006
Last updated
11/20/2007
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