Healthcare Provider Details

I. General information

NPI: 1194707760
Provider Name (Legal Business Name): BONNI FIELD MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5307 LIMESTONE RD SUITE 203
WILMINGTON DE
19808-1268
US

IV. Provider business mailing address

5307 LIMESTONE RD SUITE 203
WILMINGTON DE
19808-1268
US

V. Phone/Fax

Practice location:
  • Phone: 302-234-0890
  • Fax: 302-234-2135
Mailing address:
  • Phone: 302-234-0890
  • Fax: 302-234-2135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberC1 0003041
License Number StateDE

VIII. Authorized Official

Name: DR. BONNI FIELD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 302-234-0890