Provider Demographics
NPI:1053816645
Name:WONS, JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:WONS
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 1:8001 T W ALEXANDER DR STE 216
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4884
Mailing Address - Country:US
Mailing Address - Phone:919-350-0953
Mailing Address - Fax:919-350-0953
Practice Address - Street 1:8001 T W ALEXANDER DR STE 216
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4884
Practice Address - Country:US
Practice Address - Phone:919-350-0953
Practice Address - Fax:919-350-9818
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-00091207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine