Individual
MR. PATRICK CORKREAN BONASSO II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(855) 988-2273
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7101
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
26258
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164765830
—
WV
05
—
229327700
—
MD
Enumeration date
04/01/2013
Last updated
12/10/2022
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