Provider Demographics
NPI:1154323723
Name:BONIN, MARC M (DO)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:M
Last Name:BONIN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:111 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101
Practice Address - Country:US
Practice Address - Phone:717-988-0000
Practice Address - Fax:717-782-5716
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009340L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA814101OtherFIRST PRIORITY HEALTH
PA930100738OtherRAILROAD MEDICARE
PA001722501Medicaid
PA66490OtherBLUE SHIELD
PA066490NUTMedicare PIN
PA001722501Medicaid
PA930100738OtherRAILROAD MEDICARE