Individual
DR. DANIEL MORTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-5432
Mailing address
1336 JOHNSON RD, CHARLESTON, WV 25314-2554
(559) 905-6291
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ED01504
WV
Other
Enumeration date
06/30/2026
Last updated
06/30/2026
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