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Individual

DONALD GENE DETWEILER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-7000
(919) 350-8959
Mailing address
1121 SITUS CT STE 170, RALEIGH, NC 27606-4279
(919) 834-2767
(919) 851-4660

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
24378
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8928366
NC
Enumeration date
07/09/2006
Last updated
01/23/2019
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