Provider Demographics
NPI:1326140245
Name:MINTEER, DONALD WESLEY JR (DO)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WESLEY
Last Name:MINTEER
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-0579
Mailing Address - Country:US
Mailing Address - Phone:724-543-8164
Mailing Address - Fax:724-543-8616
Practice Address - Street 1:100 MEDICAL ARTS BLDG
Practice Address - Street 2:SUITE 130
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7135
Practice Address - Country:US
Practice Address - Phone:724-543-8531
Practice Address - Fax:724-543-8814
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS002992L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS002992LOtherPA STATE LICENSE NUMBER
PAOS002992LOtherPA STATE LICENSE NUMBER