Individual
ANTHONY BONAMINIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E WOOD ST, SRMC DEPT. INPATIENT MEDICINE, SPARTANBURG, SC 29303-3040
(864) 560-6294
Mailing address
860 PINELAND RD, UNION, SC 29379-9492
(864) 426-2153
(864) 427-0154
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
SC 20902
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189433
MEDCOST
SC
01
—
20057403
SELECT HEALTH
SC
05
—
209028
—
SC
01
—
576000934-097
TRICARE
SC
05
—
89065VC
—
NC
Enumeration date
04/26/2006
Last updated
01/08/2008
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