Weber, Lisa R

Weber, Lisa R is an individual health care provider with primary practice located at 420 E Division St , Fond Du Lac WI 54935-4560. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Weber, Lisa R can be contacted via phone (920) 926-8200.

Contact Information

Primary practice address
420 E Division St Fond Du Lac WI 54935-4560
Phone: (920) 926-8200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 51324 Wisconsin

Profile Details

NPI number 1881883635
LBN Legal business name Weber, Lisa R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2007
Last updated Dec 2nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881883635 NPPES
Wisconsin MEDICAID 34993000
Wisconsin Other P00751666

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