Healthcare Provider Details

I. General information

NPI: 1831190206
Provider Name (Legal Business Name): JOSEPH GUY DONZELLA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 MOUNT DE CHANTAL RD
WHEELING WV
26003-6357
US

IV. Provider business mailing address

1315 MOUNT DE CHANTAL RD
WHEELING WV
26003-6357
US

V. Phone/Fax

Practice location:
  • Phone: 304-243-7117
  • Fax: 304-243-5470
Mailing address:
  • Phone: 304-243-7117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1898
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: