Individual
MARIE T WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1420 ALGOMA ST, NEW LONDON, WI 54961-2104
(920) 982-8300
Mailing address
1420 ALGOMA ST, NEW LONDON, WI 54961-2104
(920) 982-8300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28117
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31545900
—
WI
Enumeration date
09/06/2005
Last updated
06/17/2008
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