Individual
MR. MICHAEL THOMAS WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1919 LATHROP ST, SUITE 209, FAIRBANKS, AK 99701
(907) 452-4446
(907) 451-9480
Mailing address
1919 LATHROP ST, SUITE 209, FAIRBANKS, AK 99701
(907) 452-4446
(907) 451-9480
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
171
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152822
MC GROUP
—
05
—
MD45451
—
AK
Enumeration date
10/03/2006
Last updated
07/08/2007
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