Healthcare Provider Details

I. General information

NPI: 1407097140
Provider Name (Legal Business Name): D'ANN ELIZABETH DUESTERHOEFT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 GARFIELD AVE
PARKERSBURG WV
26101-5340
US

IV. Provider business mailing address

3211 DUDLEY AVE
PARKERSBURG WV
26104-1813
US

V. Phone/Fax

Practice location:
  • Phone: 304-424-2590
  • Fax: 304-422-3924
Mailing address:
  • Phone: 304-422-3904
  • Fax: 304-422-3924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number19617
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: