Bonham, Brian K.

Bonham, Brian K. is an individual health care provider with primary practice located at 22911 Jefferson Blvd , Smithsburg MD 21783-1617. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Bonham, Brian K. can be contacted via phone (301) 824-3343.

Contact Information

Primary practice address
22911 Jefferson Blvd Smithsburg MD 21783-1617
Phone: (301) 824-3343
Fax: (301) 824-6323
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D0054451 Maine
Allopathic & Osteopathic Physicians / Pediatrics 208000000X D0054451 Maryland

Profile Details

NPI number 1366407975
LBN Legal business name Bonham, Brian K.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Oct 17th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366407975 NPPES
Maryland MEDICAID 507200000

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