Individual
DR. ADAM J HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
527 MEDICAL PARK DR STE 205, BRIDGEPORT, WV 26330-9009
(681) 342-3730
(304) 842-9422
Mailing address
2673 DAVISSON RUN RD STE 303, CLARKSBURG, WV 26301-7640
(800) 541-4009
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
28899
AZ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
25201
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
812976
—
AZ
01
—
WV2677A
MEDICARE PTAN
WV
Enumeration date
02/17/2006
Last updated
04/05/2022
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