Provider Demographics
NPI:1902865603
Name:BONO, BARTHOLOMEW R (MD)
Entity Type:Individual
Prefix:
First Name:BARTHOLOMEW
Middle Name:R
Last Name:BONO
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:825 OLD LANCASTER RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3231
Mailing Address - Country:US
Mailing Address - Phone:610-527-3800
Mailing Address - Fax:610-527-3296
Practice Address - Street 1:825 OLD LANCASTER RD
Practice Address - Street 2:SUITE 320
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3231
Practice Address - Country:US
Practice Address - Phone:610-527-3800
Practice Address - Fax:610-527-3296
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2017-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD074275L207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001868829Medicaid
H44685Medicare UPIN
PA049908EGWMedicare PIN