Provider Demographics
NPI:1215905195
Name:WEBER, STEPHEN FLORIAN (MD, FACP)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:FLORIAN
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-718-0440
Mailing Address - Fax:
Practice Address - Street 1:1381 WESTGATE CENTER DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2934
Practice Address - Country:US
Practice Address - Phone:336-718-0440
Practice Address - Fax:336-718-0441
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041335E207RI0200X
NC27334207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2242215OtherUNITEDHEALTHCARE
PA50054308OtherCAPITAL BLUE CROSS
PA538453OtherAETNA
PAE61269OtherHEALTHAMERICA
PA0011370380002Medicaid
PA534257OtherHIGHMARK BLUE SHIELD
PA813932OtherFIRST PRIORITY HEALTH
PA110163116Medicare PIN
PA538453OtherAETNA
PA534257Medicare PIN