Individual
DONALD FRED TETER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4415 MACCORKLE AVE SE, CHARLESTON, WV 25304-2505
(304) 926-1001
(304) 926-1003
Mailing address
4130 ROBERT C BYRD DR, BECKLEY, WV 25801-2206
(304) 252-3900
(304) 252-9311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11631
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000655
—
WV
Enumeration date
10/31/2005
Last updated
07/08/2007
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