Healthcare Provider Details

I. General information

NPI: 1760470504
Provider Name (Legal Business Name): DONATA A RECHNITZER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 36TH ST
PARKERSBURG WV
26101-1006
US

IV. Provider business mailing address

417 GRAND PARK DR STE 103
PARKERSBURG WV
26105-4049
US

V. Phone/Fax

Practice location:
  • Phone: 304-485-1044
  • Fax: 304-422-1861
Mailing address:
  • Phone: 304-485-2700
  • Fax: 304-485-0481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21555
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: