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General NPI Number Information
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NPI Number | 1578559373
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Entity Type | Individual
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Provider Name | ADOLPHUS SOLOMON BONAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 2544 COURT DR SUITE A
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City | GASTONIA
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State | NC
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Zip | 28054-3450
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Country | US
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Telephone | 704-671-6400
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Fax | 704-671-6449
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Provider Business Mailing Address
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Address Line | 2544 COURT DR SUITE A
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City | GASTONIA
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State | NC
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Zip | 28054-3450
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Country | US
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Telephone | 704-671-6400
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Fax | 704-671-6449
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 200401176
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License Number State | NC
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