Basic Information
| Provider Information | |||||||||
| NPI: | 1215905195 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBER | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | FLORIAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, FACP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 751803 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282751803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367180440 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1381 WESTGATE CENTER DR | ||||||||
| Address2: | |||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271032934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367180440 | ||||||||
| FaxNumber: | 3367180441 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 08/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | MD041335E | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RI0200X | 27334 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 2242215 | 01 | PA | UNITEDHEALTHCARE | OTHER | 50054308 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 538453 | 01 | PA | AETNA | OTHER | E61269 | 01 | PA | HEALTHAMERICA | OTHER | 0011370380002 | 05 | PA | MEDICAID | 534257 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 813932 | 01 | PA | FIRST PRIORITY HEALTH | OTHER |