MEDICARE: DR. ROBERT CHARLES BONTREGER DO

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
1	207P00000X	Emergency Medicine Physician	N72225	TX
2	207P00000X	Emergency Medicine Physician	239527	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699876458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT CHARLES BONTREGER DO

Provider Business Mailing Address
First Line	:	5413 CANONBURY RD
Second Line	:
City	:	ROSEDALE
State	:	MD
Zip	:	21237-4902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13172 HIGHWAY 287
Second Line	:
City	:	HASLET
State	:	TX
Zip	:	76052-2619
Country	:	US
Telephone Number	:	817-639-2830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	06/25/2024

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Directions to “ DR. ROBERT CHARLES BONTREGER DO” Practice Location

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