Provider Demographics
NPI:1871571059
Name:WEBER, MICHAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:WEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3480 LANDERS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2541
Mailing Address - Country:US
Mailing Address - Phone:501-978-3135
Mailing Address - Fax:501-978-3138
Practice Address - Street 1:3480 LANDERS RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2541
Practice Address - Country:US
Practice Address - Phone:501-978-3135
Practice Address - Fax:501-978-3138
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARR2574207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104669001Medicaid
AR55570C207OtherMEDICARE
AR104669001Medicaid
AR55570Medicare ID - Type Unspecified
AR55570C207OtherMEDICARE