Healthcare Provider Details

I. General information

NPI: 1356427496
Provider Name (Legal Business Name): DONALD EDWARD SWEITZER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MORRIS ST STE 103
CHARLESTON WV
25301-1409
US

IV. Provider business mailing address

600 MORRIS ST STE 103
CHARLESTON WV
25301-1409
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-7040
  • Fax: 304-388-7041
Mailing address:
  • Phone: 304-388-7040
  • Fax: 304-388-7041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number2867
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: