Individual
DR. DEBRA J TETREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 KELLIE DR, SMITHFIELD, NC 27577-9443
(919) 938-3749
(919) 938-3795
Mailing address
101 KELLIE DR, SMITHFIELD, NC 27577-9443
(919) 938-3749
(919) 938-3795
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9801088
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891038C
—
NC
Enumeration date
05/03/2006
Last updated
03/03/2021
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