Doctor Name: | MR. DONALD KEVIN ZETTERVALL |
NPI Number: | 1619959053 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RPH, CDE, CDM |
License Number: | 0901-8462 |
Business Practice Address: | 134 Boston Post Rd Suite 2 The Diabetes Center Old Saybrook, CT - 064751548 |
Business Phone Number: | 8603886677 |
Business Fax Number: | 8603883256 |
Mailing Address: | 134 Boston Post Rd, Suite 2 The Diabetes Center OLD SAYBROOK |
State: | CT |
Postal Code: | 064751548 |
Phone Number: | 8603886677 |
Fax Number: | 8603883256 |
NPI Enumeration Date: | 11/18/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 0901-8462 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CT |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |