Individual
WALTER MORSE BONNER JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
890 JOHNNIE DODDS BLVD, SUITE 2A, MT PLEASANT, SC 29464-6129
(843) 881-9971
(843) 881-9973
Mailing address
890 JOHNNIE DODDS BLVD, SUITE 2A, MT PLEASANT, SC 29464-6129
(843) 881-9971
(843) 881-9973
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
3839
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038391
—
SC
01
—
3839
STATE MEDICAL LICENSE
SC
Enumeration date
04/11/2006
Last updated
07/09/2007
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