Provider Demographics
NPI:1598989428
Name:ROBERT A. BONDI, DPM
Entity Type:Organization
Organization Name:ROBERT A. BONDI, DPM
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:816-322-3177
Mailing Address - Street 1:115 BRADFORD LN
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-2086
Mailing Address - Country:US
Mailing Address - Phone:816-322-3177
Mailing Address - Fax:816-525-5761
Practice Address - Street 1:115 BRADFORD LN
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-2086
Practice Address - Country:US
Practice Address - Phone:816-322-3177
Practice Address - Fax:816-525-5761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2010-09-20
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
MOQ370000Medicare PIN
B720000Medicare PIN
MOB670000AMedicare PIN