Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 35.126640 | OH |
NPI | 1063705150 |
---|---|
Provider Name | Bryan Joseph Bonder |
First Address | Cleveland, OH 44106-1716 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2011 |
Last Update Date | 13/01/2021 |