Individual
DR. RAM MOHAN R BONGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 ROBESON ST, STE 202, FAYETTEVILLE, NC 28301-5520
(910) 609-1630
(910) 609-1636
Mailing address
PO BOX 40908, FAYETTEVILLE, NC 28309-0908
(910) 609-6448
(910) 609-7040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
200300007
NC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
200300007
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8913352
—
NC
Enumeration date
05/31/2005
Last updated
08/06/2025
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