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Individual

TARA MELGARY HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
401 DIVISION ST, SOUTH CHARLESTON, WV 25309-1455
(304) 766-3413
(304) 766-5654
Mailing address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 414-4800
(304) 414-4801

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
28718
WV
2085R0001X
Radiation Oncology Physician
35129694
OH

Other

Enumeration date
03/29/2012
Last updated
01/05/2021
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