Provider Demographics
NPI:1215977095
Name:WEBER, ERIN B (MD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:B
Last Name:WEBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:B
Other - Last Name:SHELLHAMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7452 FULTON DR NW
Mailing Address - Street 2:STE. B
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9393
Mailing Address - Country:US
Mailing Address - Phone:330-833-4596
Mailing Address - Fax:330-833-1817
Practice Address - Street 1:7452 FULTON DR NW
Practice Address - Street 2:STE. B
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9393
Practice Address - Country:US
Practice Address - Phone:330-833-4596
Practice Address - Fax:330-833-1817
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35085452208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2625207Medicaid
OH2625207Medicaid