Provider Demographics
NPI:1376853457
Name:WARSHAW, BONNIE TERRY
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:TERRY
Last Name:WARSHAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5881 STEARMAN CT
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5971
Mailing Address - Country:US
Mailing Address - Phone:443-676-0272
Mailing Address - Fax:
Practice Address - Street 1:5881 STEARMAN CT
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5971
Practice Address - Country:US
Practice Address - Phone:443-676-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16083225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist