Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | MD09469 | OR |
NPI | 1215201413 |
---|---|
Provider Name | Dr. Donald Fraser Teal |
First Address | Eugene, OR 97403-1875 |
Second Address | Eugene, OR 97403-1875 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2012 |
Last Update Date | 06/03/2012 |