Individual
RENEE SUE WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, RD, CD, CDE
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 944-3500
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001858A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001006284
ANTHEM PTAN
IN
01
—
264430412
MEDICARE PTAN
IN
Enumeration date
06/25/2010
Last updated
04/02/2024
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