MEDICARE: PAUL VILLERE BONDY MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	34540	NC

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00152716	OTHER	NC	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1086245	OTHER	NC	UNITED HEALTH CARE
2	2729923	OTHER	NC	CIGNA HEALTHCARE
4	1362G	OTHER	NC	BCBSNC
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	6262622	OTHER	NC	AETNA
7	D4481	OTHER	NC	MEDCOST

NPI Number	:	1912991886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL VILLERE BONDY MD

Provider Business Mailing Address
First Line	:	PO BOX 7200
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-0200
Country	:	US
Telephone Number	:	252-937-0200
Fax Number	:	252-451-0056

Provider Business Practice Location Address
First Line	:	102 S EASTPOINTE AVE
Second Line	:
City	:	NASHVILLE
State	:	NC
Zip	:	27856-1849
Country	:	US
Telephone Number	:	252-459-4012
Fax Number	:	252-937-3101

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

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	11/15/2023

7500 SECURITY BLVD # C3-20-17 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244-1849

Practice Phone: 410-786-6852
Practice Fax: