Healthcare Provider Details

I. General information

NPI: 1588637250
Provider Name (Legal Business Name): CARA C BONDLY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 10TH AVE S STE 200 BRUNO CANCER CENTER
BIRMINGHAM AL
35205-1202
US

IV. Provider business mailing address

500 OFFICE PARK DR SUITE 400
BIRMINGHAM AL
35223-2437
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-7880
  • Fax: 205-939-2509
Mailing address:
  • Phone: 205-803-4330
  • Fax: 205-803-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number27228
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: