Dieter Tetatah Wefuan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2013-02459 Issued in NC

Practice address

401 N Main St
Kenansville, NC 28349-8801

Phone

(252) 214-8598

NPI assigned

Jun 15, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ashe Memorial Hospital Inc

  • Emergency Medicine Physician
  • Jefferson, NC
  • NPI 1316045800
  Medicare reassignment NPD
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment NPD
• Ashe Memorial Hospital Inc

  • Critical Access Hospital
  • Jefferson, NC
  • NPI 1376671370
  NPD
• Ashe Memorial Hospital Inc

  • Hospitalist Physician
  • Jefferson, NC
  • NPI 1861592271
  NPD
• Goshen Medical Center Incorporated

  • Federally Qualified Health Center (FQHC)
  • Wilmington, NC
  • NPI 1144170283
  NPD (past)
• Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
  • NPI 1881632339
  NPD (past)
• North Texas - Mca LLC

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1871911016
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1073834917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016436",
            "telephone_number": "910-793-4311",
            "fax_number": "910-793-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283498801",
            "telephone_number": "252-214-8598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2131 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017407",
            "country_code": "US",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1444 S 17th St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284016436",
            "country_code": "US",
            "telephone_number": "910-793-4311",
            "fax_number": "910-793-4322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEFUAN",
        "first_name": "DIETER",
        "middle_name": "TETATAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2013-02459",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2013-02459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upscale Residential Care, Inc.
• Upscale Residential Care, Incorporated
• Clarence Hughes Wagoner Jr., CRNA
• Rebecca Hinds Ward, RN
• Wayne Pharmacy, Inc.
• Amber Weifenbach
• Wellington Park Opco LLC
• Jennifer Wilson
• Luke Allan Yeager, MD
• James Austin Yoder, M.D.

• Internal Medicine Physician in Kenansville, NC
• Providers in Kenansville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.