Individual
DR. MARY CARONITI HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
14558 DANVILLE PIKE, LAUREL FORK, VA 24352-3982
(276) 398-2292
(276) 398-3331
Mailing address
PO BOX 9, LAUREL FORK, VA 24352-0009
(276) 398-2292
(276) 398-3331
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102203001
VA
208D00000X
General Practice Physician
Primary
0102203001
VA
Other
Enumeration date
07/28/2009
Last updated
07/21/2021
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