Provider Demographics
NPI:1558867457
Name:DONATHAN, CHELSEA ELIZABETH (DO)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ELIZABETH
Last Name:DONATHAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 DIANA DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:26288-9078
Mailing Address - Country:US
Mailing Address - Phone:304-847-5382
Mailing Address - Fax:304-847-5982
Practice Address - Street 1:125 DIANA DR
Practice Address - Street 2:
Practice Address - City:WEBSTER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:26288-9078
Practice Address - Country:US
Practice Address - Phone:304-847-5682
Practice Address - Fax:304-847-5982
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-01
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3766208D00000X, 208D00000X
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program