Individual
DR. CHARLES HENDERSON BONNER SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MS, CRP
Contact information
Practice address
5922 W BROAD ST, RICHMOND, VA 23230-2231
(804) 282-6953
(804) 282-8215
Mailing address
5922 W BROAD ST, RICHMOND, VA 23230-2231
(804) 282-6953
(804) 282-8215
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0715002791
VA
208600000X
Surgery Physician
0101032689
VA
Other
Enumeration date
06/21/2005
Last updated
07/18/2008
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