Organization
WAYNE R. BONLIE, M.D., P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE RUSSELL BONLIE MD (PRESIDENT)
(410) 560-7404
Entity
Organization
Contact information
Practice address
30 E PADONIA RD, SUITE 305, TIMONIUM, MD 21093-2345
(410) 560-7404
(443) 588-1725
Mailing address
30 E PADONIA RD, SUITE 305, TIMONIUM, MD 21093-2345
(410) 560-7404
(443) 588-1725
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
D0062606
MD
Other
Enumeration date
02/10/2016
Last updated
06/30/2016
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