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NPI Code Detail

MEDICARE: KENDALL FELIPE BONOT PA-C

MEDICARE: KENDALL FELIPE BONOT PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601008408MI
2363A00000XPhysician Assistant0010-08760NC

General Provider Information

NPI Number : 1487166906
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDALL FELIPE BONOT PA-C
Provider Business Mailing Address
First Line : 3101 JOHN HUMPHRIES WYND
Second Line :
City : RALEIGH
State : NC
Zip : 27612-5302
Country : US
Telephone Number : 919-881-8272
Fax Number :
Provider Business Practice Location Address
First Line : 3101 JOHN HUMPHRIES WYND
Second Line :
City : RALEIGH
State : NC
Zip : 27612-5302
Country : US
Telephone Number : 919-881-8272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2017
Last Update Date : 07/23/2021

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Directions to “ KENDALL FELIPE BONOT PA-C” Practice Location

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