Individual
DANIEL JOSEPH BONTHIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 BLYTHE BLVD, CHARLOTTE, NC 28203-5866
(704) 381-1450
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2019-01232
NC
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
2019-01232
NC
Other
Enumeration date
09/13/2005
Last updated
07/15/2024
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