Provider Demographics
NPI:1326080698
Name:FIELD, BONNI (MD)
Entity Type:Individual
Prefix:DR
First Name:BONNI
Middle Name:
Last Name:FIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 AAA BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-3624
Mailing Address - Country:US
Mailing Address - Phone:302-918-6400
Mailing Address - Fax:302-918-6412
Practice Address - Street 1:875 AAA BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3624
Practice Address - Country:US
Practice Address - Phone:302-918-6400
Practice Address - Fax:302-918-6412
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1 0003041208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000183301Medicaid