Individual
DR. DONALD ALBERT DESHETLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 NEWARK GRANVILLE RD, SUITE 100, GRANVILLE, OH 43023-9135
(740) 587-0087
(740) 587-0084
Mailing address
2000 NEWARK GRANVILLE RD, SUITE 100, GRANVILLE, OH 43023-9135
(740) 587-0087
(740) 587-0084
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35076727D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080148293
RAILROAD MEDICARE
OH
05
—
2130956
—
OH
Enumeration date
06/30/2005
Last updated
02/24/2016
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