Provider Demographics
NPI:1487187969
Name:ROBERT A BONDI
Entity Type:Organization
Organization Name:ROBERT A BONDI
Other - Org Name:ROBERT & LAUREL BONDI, DPM
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BONDI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:816-525-4778
Mailing Address - Street 1:224 NE TUDOR RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5696
Mailing Address - Country:US
Mailing Address - Phone:816-525-4778
Mailing Address - Fax:816-525-5761
Practice Address - Street 1:224 NE TUDOR RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5696
Practice Address - Country:US
Practice Address - Phone:816-525-4778
Practice Address - Fax:816-525-5761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODA0651OtherRAILROAD MEDICARE
13183011OtherBLUE CROSS BLUE SHIELD
MODA0651OtherRAILROAD MEDICARE
13183011OtherBLUE CROSS BLUE SHIELD
MOB670000AMedicare PIN