Provider Demographics
NPI:1164050217
Name:WEBER, SEAN ALEXANDER (DO)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:ALEXANDER
Last Name:WEBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-878-6520
Mailing Address - Fax:336-878-6521
Practice Address - Street 1:611 N LINDSAY ST STE 102&200
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4300
Practice Address - Country:US
Practice Address - Phone:336-878-6520
Practice Address - Fax:336-878-6521
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.079193208100000X
NC2025-01165208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation