Provider Demographics
NPI:1770143067
Name:BONNIN, DAVID EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDWARD
Last Name:BONNIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:655 WATKINS MILL RD FL 5
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:D.D. EISENHOWER ARMY MEDICAL CENTER
Practice Address - Street 2:300 E. HOSPITAL ROAD
Practice Address - City:FORT EISENHOWER
Practice Address - State:GA
Practice Address - Zip Code:30805
Practice Address - Country:US
Practice Address - Phone:706-787-6945
Practice Address - Fax:706-787-0304
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2025-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2019019484207R00000X
DCMD210002478207R00000X
MDD0094575207R00000X
VA0101275351207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine