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Individual
DR. BONNIE J DATTEL
Active
Individual
DR. BONNIE J DATTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101048500
VA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
0101048500
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-010
TRICARE/CHAMPUS
VA
05
—
006259995
—
VA
01
—
0595T
BC/BS
NC
01
—
092616
ANTHEM
VA
01
—
14051
SENTARA OPTIMA
VA
01
—
227480
UHC/MAMSI
VA
05
—
890595T
—
NC
01
—
G43784
MEDICAL LICENSE
CA
01
—
PAR
VIRGINIA HEALTH NETWORK
VA
Enumeration date
02/10/2006
Last updated
06/08/2015
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