| Wayne R. Bonlie, M.d., P.a | |
|
30 E Padonia Rd Suite 305 Timonium MD 21093-2345 | |
| (410) 560-7404 | |
| (443) 588-1725 |
| Full Name | Wayne R. Bonlie, M.d., P.a |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 30 E Padonia Rd, Timonium, Maryland |
| Authorized Official Name and Position | Wayne Russell Bonlie (PRESIDENT) |
| Authorized Official Contact | 4105607404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne R. Bonlie, M.d., P.a 30 E Padonia Rd Suite 305 Timonium MD 21093-2345 Ph: (410) 560-7404 | Wayne R. Bonlie, M.d., P.a 30 E Padonia Rd Suite 305 Timonium MD 21093-2345 Ph: (410) 560-7404 |
| NPI Number | 1881052454 |
|---|---|
| Provider Enumeration Date | 02/10/2016 |
| Last Update Date | 06/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881052454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | D0062606 (Maryland) | Primary |
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