Individual
ETHAN WESLEY MCDONALD I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 MEDICAL PARK STE 104, WHEELING, WV 26003-6389
(304) 242-4800
Mailing address
206 MACALLAN LN UNIT 1, TRIADELPHIA, WV 26059-2464
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2647
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/06/2021
Last updated
12/06/2022
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