| Organization Name: | TIMOTHY J DONATELLI DPM INC |
| NPI Number: | 1003251141 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN DONOFRIO (MANAGER) |
| Mailing Address: | 2036 Leatherwood Ln Bluefield |
| State: | VA US |
| Postal Code: | 246052020 |
| Phone Number: | 8002923008 |
| Fax Number: | 8664204578 |
| NPI Enumeration Date: | 05/02/2013 |
| NPI Last Update Date: | 05/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 0103300831 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |