Provider Demographics
NPI:1558045690
Name:BIONIC MEDICAL PLLC
Entity Type:Organization
Organization Name:BIONIC MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:PELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-242-0031
Mailing Address - Street 1:4110 COBSCOOK DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5706
Mailing Address - Country:US
Mailing Address - Phone:114-342-4200
Mailing Address - Fax:
Practice Address - Street 1:600 OFFICE PARK DR
Practice Address - Street 2:SUITE 140
Practice Address - City:RESEARCH TRIANGLE PARK
Practice Address - State:NC
Practice Address - Zip Code:27709
Practice Address - Country:US
Practice Address - Phone:434-242-0031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center