Provider Demographics
NPI:1194428201
Name:PERRI L BONAR DPM PLLC
Entity type:Organization
Organization Name:PERRI L BONAR DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:BONAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:703-687-1985
Mailing Address - Street 1:37279 HUNT VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-4364
Mailing Address - Country:US
Mailing Address - Phone:703-687-1985
Mailing Address - Fax:
Practice Address - Street 1:37279 HUNT VALLEY LN
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-4364
Practice Address - Country:US
Practice Address - Phone:703-687-1985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty