Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | D0059784 | MD |
NPI | 1013976414 |
---|---|
Provider Name | Joyce A Bonsu |
First Address | Baltimore, MD 21229-5218 |
Second Address | Baltimore, MD 21229-5218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 25/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0040 | CAREFIRST-DC (01) | MD |
401434100 | (05) | MD |
618993-03 | CAREFIRST-MD (01) | MD |
H24870 | (02) |