Provider Demographics
NPI:1568756062
Name:STAHL, BONNI LAUNDRIE (MD)
Entity Type:Individual
Prefix:DR
First Name:BONNI
Middle Name:LAUNDRIE
Last Name:STAHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BONNI
Other - Middle Name:E
Other - Last Name:LAUNDRIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-2935
Mailing Address - Country:US
Mailing Address - Phone:617-284-7000
Mailing Address - Fax:
Practice Address - Street 1:300 BROADWAY
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-2935
Practice Address - Country:US
Practice Address - Phone:617-284-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253053207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine