Healthcare Provider Details
I. General information
NPI: 1487187969
Provider Name (Legal Business Name): ROBERT A BONDI
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/11/2017
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
224 NE TUDOR RD
LEES SUMMIT MO
64086-5696
US
IV. Provider business mailing address
224 NE TUDOR RD
LEES SUMMIT MO
64086-5696
US
V. Phone/Fax
- Phone: 816-525-4778
- Fax: 816-525-5761
- Phone: 816-525-4778
- Fax: 816-525-5761
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
A
BONDI
Title or Position: OWNER
Credential: DPM
Phone: 816-525-4778