Provider Demographics
NPI:1487877551
Name:TEMPLETON, BONNIE HEATHER (MD)
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:HEATHER
Last Name:TEMPLETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:HEATHER
Other - Last Name:SCIAMBRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:411 1/2 D STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-2533
Mailing Address - Country:US
Mailing Address - Phone:855-997-7900
Mailing Address - Fax:304-701-2545
Practice Address - Street 1:411 1/2 D STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-2533
Practice Address - Country:US
Practice Address - Phone:855-997-7900
Practice Address - Fax:304-701-2545
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0078684207Q00000X
AK6796207Q00000X
WV28202207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD8227Medicaid