Individual
CHARLES J. BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
746 JEFFERSON AVE, THE WOUND CENTER, SCRANTON, PA 18510-1624
(570) 340-5824
(570) 340-5844
Mailing address
746 JEFFERSON AVE, THE WOUND CENTER, SCRANTON, PA 18510-1921
(570) 340-5824
(570) 340-5844
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD028552L
PA
Other
Enumeration date
05/25/2006
Last updated
08/23/2009
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