Provider Demographics
NPI:1154451318
Name:WEBB, MICHAEL DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 WILLAMETTE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3309
Mailing Address - Country:US
Mailing Address - Phone:541-344-3423
Mailing Address - Fax:
Practice Address - Street 1:3225 WILLAMETTE ST STE 2
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3309
Practice Address - Country:US
Practice Address - Phone:541-344-3423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR157172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR167874OtherMHN
OR201079Medicaid
ORJ3064-03OtherPACIFICSOURCE
OR931130894-03OtherPROVIDENCE INSURANCE
OR8000894OtherHMOO
ORORW916DOtherODS
ORC87048Medicare UPIN
ORROOWCBBHDMedicare PIN