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Individual

EDWARD VINCENT BONYAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
95 HARRIS RD # MOB1, KILMARNOCK, VA 22482-3845
(804) 435-7735
Mailing address
2410 ATHERHOLT RD, LYNCHBURG, VA 24501-2148
(434) 200-5252
(434) 200-5252

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101048188
VA
207RC0000X
Cardiovascular Disease Physician
20934
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000486018
WV BLUE SHIELD
01
000875693
WV BLUE SHIELD - GROUP #
05
006051120
VA
05
0086502000
WV
01
08251100000
QUALCHOICE
01
211032
ANTHEM PROFESSIONAL
01
2119629
MAMSI PROFESSIONAL
01
3810003817
WV MEDICAID GROUP
WV
01
43935
SENTARA PROFESSIONAL
01
550941600
MD MEDICAID GRP IN VA
MD
01
9332051
WV MEDICARE GRP OLD
WV
01
9371521
WV MEDICARE B - GROUP #
WV
01
C00085
VA MEDICARE B - GROUP #
01
P00656327
RAILROAD MEDICARE
Enumeration date
04/06/2006
Last updated
04/17/2025
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