Individual
THOMAS RICHARD WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 6018B, SAINT LOUIS, MO 63141-8232
(314) 251-5940
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
01029263A
IN
2086S0120X
Pediatric Surgery Physician
036121829
IL
2086S0120X
Pediatric Surgery Physician
2014039525
MO
2086S0120X
Pediatric Surgery Physician
240390
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201142010
—
IN
01
—
P01291673
RAILROAD MEDICARE
IN
Enumeration date
07/24/2006
Last updated
07/10/2015
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