Individual
DR. JONATHAN J HENNESSEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
134 OWENSVILLE ROAD, WEST RIVER, MD 20778
(410) 867-4700
(410) 867-8754
Mailing address
134 OWENSVILLE ROAD, WEST RIVER, MD 20778
(410) 867-4700
(410) 867-8754
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H76407
MD
207Q00000X
Family Medicine Physician
RT-2118
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404482700
—
MD
Enumeration date
06/23/2010
Last updated
02/14/2017
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