DRS Tabor & Weber PA

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

DRS TABOR & WEBER PA

Practice address

702 Russell Ave
Suite 103
Gaithersburg, MD 20877-2606

Phone

(301) 948-3668

Fax

(301) 926-7787

NPI assigned

Mar 13, 2007

Last updated

Sep 11, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Lawrence Michetti, DPMNPI 1245220789

Title

President

Phone

(301) 948-3668

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Drs Michetti Tabor & Weber PA Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Lawrence Michetti, DPM

  • Foot & Ankle Surgery Podiatrist
  • Gaithersburg, MD
  • NPI 1245220789
  Authorized official Same address or phone
• Matthew John Keast, D.P.M.

  • Podiatrist
  • Springfield, VA
  • NPI 1376505842
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1285767723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 RUSSELL AVE",
            "address_2": "SUITE 103",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772606",
            "telephone_number": "301-948-3668",
            "fax_number": "301-926-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 RUSSELL AVE",
            "address_2": "SUITE 103",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772606",
            "telephone_number": "301-948-3668",
            "fax_number": "301-926-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS TABOR & WEBER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "MICHETTI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-948-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214348800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "KU36MI",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NCA",
            "identifier": "7121",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs Michetti Tabor & Weber PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Derrick Drake
• Jolene Drblik, PSY.D.
• Dream Smiles Pediatric Dentistry of Gaithersburg
• Harley Dresner
• Melania Driver
• DRS. Ford and Rothman Cosmetic and Clinical Dermatology, LLC
• DRS. Sweeney, Wise and Romanow, DDS, DMD, PA
• DRS. Sweeney, Wise and Romanow, DDS, DMD, PA
• DRS. Sweeney, Wise and Romanow, DDS,DMD,PA
• Ruofei Du

• Foot & Ankle Surgery Podiatrist in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Foot & Ankle Surgery Podiatrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.