Basic Information
| Provider Information | |||||||||
| NPI: | 1861481715 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WEEBER | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8019 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011028000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664314077 | ||||||||
| FaxNumber: | 4137747448 | ||||||||
| Practice Location | |||||||||
| Address1: | 31 HALL DR | ||||||||
| Address2: | AMHERST MEDICAL CENTER | ||||||||
| City: | AMHERST | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010022751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132568561 | ||||||||
| FaxNumber: | 4132564421 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2005 | ||||||||
| LastUpdateDate: | 06/17/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 30247 | MA | Y | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | H15014 | 01 | MA | BLUE CROSS BLUE SHIELD-MA | OTHER | 2357592 | 01 | MA | AETNA | OTHER | 24210 | 01 | MA | HEALTH NEW ENGLAND | OTHER | 1294774 | 01 | MA | FALLON | OTHER | 0191582 | 05 | MA | MEDICAID | 030247-7879 | 01 | CONNECTICARE | OTHER | C57084 | 01 | MA | HARVARD PILGRIM HEALTH CARE | OTHER | 000000008368 | 01 | MA | BMC | OTHER | 102778 | 01 | MA | CIGNA | OTHER | 2155349 04 | 01 | MA | UNITED HEALTH CARE | OTHER |