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Individual

DIETER TETATAH WEFUAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
401 N MAIN ST, KENANSVILLE, NC 28349-8801
(252) 214-8598
Mailing address
1444 S 17TH ST, WILMINGTON, NC 28401-6436
(910) 793-4311
(910) 793-4322

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2013-02459
NC
208000000X
Pediatrics Physician
2013-02459
NC

Other

Enumeration date
06/15/2010
Last updated
04/24/2019
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