Individual
JAMES M. BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
509 N BROAD ST, WOODBURY, NJ 08096-1617
(856) 853-2001
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
(856) 686-4300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MB50408
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230557000
AMERIHEALTH
NJ
01
—
1079529
KEY/MER
NJ
05
—
2013100
—
NJ
Enumeration date
07/19/2006
Last updated
07/17/2007
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