Healthcare Provider Details

I. General information

NPI: 1881096915
Provider Name (Legal Business Name): HAROLD E. BONDY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 S. CARLIN SPRINGS ROAD SUITE 203
ARLINGTON VA
22204-1078
US

IV. Provider business mailing address

611 S. CARLIN SPRINGS ROAD SUITE 203
ARLINGTON VA
22204-1078
US

V. Phone/Fax

Practice location:
  • Phone: 703-671-4720
  • Fax: 703-671-4781
Mailing address:
  • Phone: 703-671-4720
  • Fax: 703-671-4781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0101026897
License Number StateVA

VIII. Authorized Official

Name: MR. HAROLD E. BONDY
Title or Position: PRESIDENT
Credential: MD
Phone: 703-671-4720