MEDICARE: EDWARD VINCENT BONYAK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	20934	WV
2	207RC0000X	Cardiovascular Disease Physician	0101048188	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	9332051	OTHER	WV	WV MEDICARE GRP OLD
7	9371521	OTHER	WV	WV MEDICARE B - GROUP #
8	C00085	OTHER		VA MEDICARE B - GROUP #
11	9332051	OTHER	WV	WV MEDICARE B - GROUP #
13	P00656327	OTHER		RAILROAD MEDICARE
16	9371521	OTHER	WV	WV MEDICARE GRP NEW

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	08251100000	OTHER	QUALCHOICE
5	2119629	OTHER	MAMSI PROFESSIONAL
6	000486018	OTHER	WV BLUE SHIELD
9	000875693	OTHER	WV BLUE SHIELD - GROUP #
10	211032	OTHER	ANTHEM PROFESSIONAL
12	43935	OTHER	SENTARA PROFESSIONAL
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003878794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD VINCENT BONYAK MD

Provider Business Mailing Address
First Line	:	2410 ATHERHOLT RD
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24501-2148
Country	:	US
Telephone Number	:	434-200-5252
Fax Number	:	434-200-5252

Provider Business Practice Location Address
First Line	:	95 HARRIS RD # MOB1
Second Line	:
City	:	KILMARNOCK
State	:	VA
Zip	:	22482-3845
Country	:	US
Telephone Number	:	804-435-7735
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	04/17/2025

Similar Medicare Providers

1982601738 — KELLY M STRICKLAND PA
Practice Location Address:

86 HARRIS RD
KILMARNOCK, VA
22482-3845

Practice Phone: 804-435-2651
Practice Fax:

1750374005 — DR. DAVID RICHARD ANTONIO M.D.
Practice Location Address:

95 HARRIS RD , BUILDING 5
KILMARNOCK, VA
22482-3845

Practice Phone: 804-435-3146
Practice Fax: 804-435-6054

1619960952 — DR. ROBERT WILLIAM POOLE M.D.
Practice Location Address:

95 HARRIS RD , BUILDING 5
KILMARNOCK, VA
22482-3845

Practice Phone: 804-435-3146
Practice Fax: 804-435-6054

1437139078 — JAMES A MCCOIG MD
Practice Location Address:

95 HARRIS RD , BLDG #5
KILMARNOCK, VA
22482-3845

Practice Phone: 804-435-3146
Practice Fax:

1457311748 — NORTHERN NECK NEPHROLOGY PC
Practice Location Address:

86 HARRIS RD
KILMARNOCK, VA
22482-3845

Practice Phone: 804-435-2651
Practice Fax: 804-435-2302

1366402455 — VICKI A KINSEL MD
Practice Location Address:

86 HARRIS RD
KILMARNOCK, VA
22482-3845

Practice Phone: 804-435-2651
Practice Fax: 804-435-2302

Directions to “ EDWARD VINCENT BONYAK MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.