IndividualActive
Donald Ta, M.D.
NPI 1376812008 · Pediatrics Physician · Clendenin, WV
Provider details
- NPI number
- 1376812008
- Entity type
- Individual
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 27153 (WV)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
107 Koontz Ave
Clendenin, WV 25045-9578
Phone: (304) 548-7272
Fax: (304) 548-7149
Approximate (ZIP-level) locationGet directions
Mailing address
104 Alex Ln
Charleston, WV 25304-2952
Registry dates
- Enumerated
- 2011-12-27
- Last updated
- 2020-05-21
- Certified
- 2020-05-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.