Individual
DR. JONATHAN LONG HANOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506
(304) 598-4000
Mailing address
204 WAITMAN ST, MORGANTOWN, WV 26501-7532
(301) 785-4659
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D71251
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520049100
—
MD
Enumeration date
06/28/2007
Last updated
06/21/2011
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