Provider Demographics
NPI:1982936563
Name:WEBER, TIMOTHY DAVID (RPH)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:DAVID
Last Name:WEBER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 BEACON RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9820
Mailing Address - Country:US
Mailing Address - Phone:984-234-0195
Mailing Address - Fax:
Practice Address - Street 1:424 BEACON RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-9820
Practice Address - Country:US
Practice Address - Phone:984-234-0195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2024-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02679500183500000X
NC15814183500000X
PARP443224183500000X
OHRPH.03230831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist