Provider Demographics
NPI:1932105194
Name:BONDER, RICHARD H (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:H
Last Name:BONDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 LIMESTONE RD
Mailing Address - Street 2:STE 202
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5400
Mailing Address - Country:US
Mailing Address - Phone:302-999-0075
Mailing Address - Fax:302-995-0189
Practice Address - Street 1:1941 LIMESTONE RD
Practice Address - Street 2:STE 202
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5400
Practice Address - Country:US
Practice Address - Phone:302-999-0075
Practice Address - Fax:302-995-0189
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECI-0000679207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0079504000OtherAMERIHEALTH
0079504000OtherAMERIHEALTH
103032Medicare ID - Type Unspecified