Individual
PATRICK CORKREAN BONASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1703 LOCUST AVE, FAIRMONT, WV 26554-1320
(304) 366-6100
(304) 366-2220
Mailing address
1703 LOCUST AVE, FAIRMONT, WV 26554-1320
(304) 366-6100
(304) 366-2220
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
WV13108
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0094765000
—
WV
Enumeration date
09/21/2006
Last updated
11/20/2020
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