Individual provider · NPI-1

Dr. Charles Henderson Bonner Sr., MD, MS, CRP

Physical Medicine & Rehabilitation · Richmond, VA

NPI number1710983283
StatusActive
Last updated in NPPESJul 18, 2008

Details

NPI
1710983283
Entity type
Individual (NPI-1)
Name
Dr. Charles Henderson Bonner Sr.
Credential
MD, MS, CRP
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 21, 2005
Last updated
Jul 18, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208100000X Physical Medicine & Rehabilitation0715002791VAYes
208600000X Surgery0101032689VA

Practice location

5922 W Broad St
Richmond, VA 23230-2231

Phone 804-282-6953 · Fax 804-282-8215

Mailing address

5922 W Broad St
Richmond, VA 23230-2231

Phone 804-282-6953 · Fax 804-282-8215

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