Provider Demographics
NPI:1093785420
Name:MOFFITT, DONALD R (M D)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:MOFFITT
Suffix:
Gender:M
Credentials:M D
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Mailing Address - Street 1:8209 22ND STREET CT W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-2936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MADIGAN ARMY MEDICAL CENTER
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-0001
Practice Address - Country:US
Practice Address - Phone:253-968-1980
Practice Address - Fax:253-968-0384
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO228952080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology