Provider Demographics
NPI:1063924900
Name:BONADIO, FRANCIS ANTHONY JR (PHD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:ANTHONY
Last Name:BONADIO
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:BONADIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:49 OLD SOLOMONS ISLAND RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3864
Mailing Address - Country:US
Mailing Address - Phone:443-219-6440
Mailing Address - Fax:
Practice Address - Street 1:49 OLD SOLOMONS ISLAND RD STE 200
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3864
Practice Address - Country:US
Practice Address - Phone:443-219-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-01
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06820103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical