Michael Bonner, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3523 Issued in MD

Practice address

106 Milford St
Suite 104
Salisbury, MD 21804-6953

Phone

(410) 543-8291

Fax

(410) 341-6275

NPI assigned

Aug 22, 2006

Last updated

Sep 18, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Atlantic Psychological Practice, P.a.

  • Clinical Child & Adolescent Psychologist
  • Salisbury, MD
  • NPI 1821031543
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1891801619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "address_2": "SUITE 104",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-543-8291",
            "fax_number": "410-341-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "address_2": "SUITE 104",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-543-8291",
            "fax_number": "410-341-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "3523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "821701700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirk-John Bogle
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• Babatunde Bolarinwa, PHARM.D
• Savannah Bolick
• Emily Boniface
• Mary Ann Booth, MD
• Manjula Prakash Borge, M.D.
• Kenneth Alan Bortnick, O.D.
• Meredith Gwen Borzotta, CRNP
• Boscovs Department Store LLC (Boscov's Optical)

• Clinical Psychologist in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.