Individual
DR. KIRBY WAYNE BONVILLAIN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 MOREHEAD MEDICAL DR STE 300, CHARLOTTE, NC 28204-2966
(704) 446-2772
(704) 355-2467
Mailing address
1025 MOREHEAD MEDICAL DR STE 300, CHARLOTTE, NC 28204-2966
(704) 446-2772
(704) 355-2467
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
BONV-MC1W4U
NC
Other
Enumeration date
03/29/2021
Last updated
03/29/2021
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