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General NPI Number Information
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NPI Number | 1508250440
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Entity Type | Individual
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Provider Name | JENNA R. BONNER M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 9000 FRANKLIN SQUARE DRIVE DEPT OF EMERGENCY MEDICINE
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City | BALTIMORE
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State | MD
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Zip | 21237
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Country | US
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Telephone | 443-777-7606
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Fax | 443-777-7587
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Provider Business Mailing Address
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Address Line | 9000 FRANKLIN SQUARE DRIVE DEPT OF EMERGENCY MEDICINE
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City | BALTIMORE
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State | MD
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Zip | 21237
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Country | US
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Telephone | 443-777-7606
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Fax | 443-777-7587
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | D0084860
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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