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Individual

MARILYN JUDY BONFILI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 HUNTINGTON WAY STE 100, FAIRMONT, WV 26554-8819
(304) 368-2422
(304) 368-2426
Mailing address
1 HUNTINGTON WAY STE 100, FAIRMONT, WV 26554-8819
(304) 368-2422
(304) 368-2426

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20406
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1809565000
WV
05
1809565001
WV
Enumeration date
07/26/2005
Last updated
05/25/2022
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