Organization
NETTLE CREEK HEALTH CARE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM M WEBER MD (OWNER)
(765) 489-4578
Entity
Organization
Contact information
Practice address
4829 N STATE ROAD 1, SUITE 1, HAGERSTOWN, IN 47346
(765) 489-4578
(765) 489-5135
Mailing address
PO BOX 189, HAGERSTOWN, IN 47346
(765) 489-4578
(765) 489-5135
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045014
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200335270A
—
IN
Enumeration date
12/21/2006
Last updated
11/25/2008
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