Individual
DR. HUGH BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1641 N RIDLEY CREEK RD, MEDIA, PA 19063-2023
(610) 565-6986
Mailing address
1641 N RIDLEY CREEK RD, MEDIA, PA 19063-2023
(610) 565-6986
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD010107E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3415G196
PA LICENSE NO
PA
Enumeration date
02/15/2012
Last updated
02/15/2012
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