MEDICARE: DR. JONATHAN WONS 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	207Q00000X	Family Medicine Physician	2021-00091	NC

General Provider Information

NPI Number	:	1053816645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN WONS MD

Provider Business Mailing Address
First Line	:	8001 T W ALEXANDER DR STE 216
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-4884
Country	:	US
Telephone Number	:	919-350-0953
Fax Number	:	919-350-0953

Provider Business Practice Location Address
First Line	:	8001 T W ALEXANDER DR STE 216
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-4884
Country	:	US
Telephone Number	:	919-350-0953
Fax Number	:	919-350-9818

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

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	01/26/2023

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