Provider Demographics
NPI:1366928103
Name:WEBER, JAMES ANDREW
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:WEBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 CRAWFORDSVILLE RD STE Q
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46224-3726
Mailing Address - Country:US
Mailing Address - Phone:317-388-8144
Mailing Address - Fax:317-388-8160
Practice Address - Street 1:5620 CRAWFORDSVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46224-3725
Practice Address - Country:US
Practice Address - Phone:317-388-8144
Practice Address - Fax:317-388-8160
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001472A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN17001472AOtherSTATE OF INDIANA