Individual
DOLORES YVONNE TETREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
27 GAMECOCK AVE, STE 201, CHARLESTON, SC 29407-3398
(843) 769-8215
(843) 769-8216
Mailing address
27 GAMECOCK AVE, STE 201, CHARLESTON, SC 29407-3398
(843) 769-8215
(843) 769-8216
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
171005
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
33970
SC
Other
Enumeration date
06/22/2006
Last updated
11/07/2014
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