Provider Demographics
NPI:1548526411
Name:BONNER, EARIC RAMON (MD)
Entity type:Individual
Prefix:DR
First Name:EARIC
Middle Name:RAMON
Last Name:BONNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:105 MARK DR
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-1777
Mailing Address - Country:US
Mailing Address - Phone:252-482-6530
Mailing Address - Fax:252-482-6531
Practice Address - Street 1:105 MARK DR
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1777
Practice Address - Country:US
Practice Address - Phone:252-482-6530
Practice Address - Fax:252-482-6531
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-02075208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist