WAYNE RUSSSELL BONLIE M.D. NPI 1093770042

NPI Information

  • NPI: 1093770042
  • Provider Name: WAYNE RUSSSELL BONLIE, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 30 E PADONIA RD
    SUITE 305
    TIMONIUM, MD
    ZIP 21093
  • Phone: (410) 560-7404

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NPI Details

Wayne Russsell Bonlie, M.D. is a family medicine in Timonium, MD. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Wayne Russsell Bonlie, M.D. NPI is 1093770042. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

30 E PADONIA RD
SUITE 305
TIMONIUM, MD
ZIP 21093-345
Phone: (410) 560-7404
Fax: (443) 588-1725

The NPI 1093770042 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/20/2006 and was last updated on 1/26/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineD0062606MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F61293MEDICARE UPINMARYLAND
2150010ZDDBMEDICARE PINMARYLAND
3945LL573MEDICARE PINMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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