Individual
DR. GRANT HOWARD BONAVIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8901 WISCONSIN AVE, BETHESDA, MD 20889-0001
(301) 295-5050
Mailing address
4412 SAUL RD, KENSINGTON, MD 20895-3731
(301) 761-3073
(301) 761-3073
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101237017
VA
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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