Marie Rose Bonabon, M.D.
Individual provider Active NPI Pediatrics Physician · Mauldin, SC
NPI 1093775397 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1093775397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 23996 (SC)
- Practice address
- 309 W Butler Rd
Mauldin, SC 29662-2531 - Phone
- (864) 297-1575
- Fax
- (864) 284-0844
- NPI assigned
- Mar 23, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 23996 | SC | Yes |
Addresses
Primary practice location
309 W Butler Rd
Mauldin, SC 29662-2531
Mailing address
800 Pelham Rd
Greenville, SC 29615-3300
Phone (864) 234-5800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 239969 | Medicaid | SC |
Other providers in Mauldin, SC
- Jennifer S Bertram
- Marija Betejeva
- Laura Black
- Blue Ridge Foot and Ankle, LLC
- Devan Scott Bolf
- Margaret Bongiovanni
- Sara Borkosky
- Gwendolyn Barton Bozeman
- Heather L. Brannon
- Margaret Brannon
All providers in Mauldin, SC · Pediatrics Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.