Individual
DEAN J BONSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-9193
(336) 716-1322
Mailing address
PO BOX 780, 1 STADIUM DRIVE, MORGANTOWN, WV 26507-0780
(304) 285-7101
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2018-02030
NC
207W00000X
Ophthalmology Physician
24355
WV
207W00000X
Ophthalmology Physician
35.086275
OH
208000000X
Pediatrics Physician
35-08-6275
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810004592
—
WV
Enumeration date
07/09/2006
Last updated
07/02/2019
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