Provider Demographics
NPI:1053334417
Name:BONNER, STEVEN H (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:H
Last Name:BONNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 COLUMBIANA ROAD
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2158
Mailing Address - Country:US
Mailing Address - Phone:205-536-8400
Mailing Address - Fax:205-521-7078
Practice Address - Street 1:2090 COLUMBIANA ROAD
Practice Address - Street 2:SUITE 4000
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-2158
Practice Address - Country:US
Practice Address - Phone:205-536-8400
Practice Address - Fax:205-521-7078
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22502174400000X, 2084P0800X
ALMD.225022084P0800X
GA684842084P0800X
OH35.1234062084P0800X
IAMD-417512084P0800X
VA01012563962084P0800X
MO20140250472084P0800X
NV154522084P0800X
NMMD2014-07052084P0800X
FLME-1212392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG93097Medicare UPIN