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Individual

BONNI ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
361 FAIR HILL DR, ELKTON, MD 21921-2512
(410) 620-7260
(410) 620-7262
Mailing address
PO BOX 190, ELKTON, MD 21922-0190
(410) 398-4679
(410) 620-3686

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C2-0007295
DE
207Q00000X
Family Medicine Physician
Primary
H0062851
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
408570100
MD
01
P00266351
MEDICARE RAILROAD
Enumeration date
04/26/2006
Last updated
05/05/2008
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