Provider Demographics
NPI:1144363193
Name:WEBBER, FREDERICK N (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:N
Last Name:WEBBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 SINCLAIR LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-2030
Mailing Address - Country:US
Mailing Address - Phone:410-366-1151
Mailing Address - Fax:410-366-1151
Practice Address - Street 1:3425 SINCLAIR LN
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-2030
Practice Address - Country:US
Practice Address - Phone:410-366-1151
Practice Address - Fax:410-366-0032
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00546602084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB86570Medicare UPIN
MDS676280ZMedicare PIN