NPI 1649628306 · live from the CMS NPI Registry
Jason Andrew Bonomo, MD, PhD
Internal Medicine, Cardiovascular Disease in Fairfax, VA. National Provider Identifier 1649628306, active.
NPI record
| NPI | 1649628306 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Internal Medicine, Cardiovascular Disease 207RC0000X |
| Practice location | 8081 Innovation Park Dr Ste 700, Fairfax, VA 22031 |
| Practice phone | 571-472-2900 |
| Mailing address | Po Box 37174, Baltimore, MD 21297 |
| Enumerated | June 2, 2016 |
| Last updated | October 28, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine | 207R00000X | 0101274803 (VA) |
| Hospitalist | 208M00000X | 036.149207 (IL) |
| Internal Medicine, Cardiovascular Disease primary | 207RC0000X | 0101274803 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.