Provider Demographics
NPI:1215197199
Name:BONZON, CHRISTOPHER JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JEFFREY
Last Name:BONZON
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 1:101 MANNING DR
Mailing Address - Street 2:PHYSICAL MEDICINE AND REHABILITATION
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:919-966-8812
Mailing Address - Fax:919-966-0083
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:PHYSICAL MEDICINE AND REHABILITATION
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-1072
Practice Address - Fax:919-966-0290
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC149240390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program