DR. MARISSA ELIZABETH BONYUN (NPI# 1790338341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790338341 |
| Entity Type | Individual |
| Full Name | DR. MARISSA ELIZABETH BONYUN |
| Credential | MD, MED, FRCSC |
| Practice Address |
22 S Greene St Baltimore MD 21201-1544 |
| Mailing Address |
Po Box 636256 Cincinnati OH 45263-6256 |
| Practice Telephone | 4103286280 |
| Mailing Telephone | 5135856200 |
| Mailing Fax Number | 5132453672 |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2020-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
35.139373 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CPSO | 104120 | 01 |
| Street Address |
22 S GREENE ST |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21201-1544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383063 | Malinda Daniel Duke | Nurse Practitioner | 22 S Greene St, Rm N6w84, Baltimore, MD 21201-1544 | 2005-06-01 |
| 1891396784 | Tamara Wiseman | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-11-05 |
| 1063012664 | Shawna Marie Hutton | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-11-01 |
| 1124625413 | Kerry Ann Lambert | Pharmacist | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-08 |
| 1730786104 | Joseph William Russo | Pediatrics | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-07 |
| 1295342327 | Leah Marie Dubose | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-23 |
| 1275147167 | Rosalynn Joy Allen | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-09-08 |
| 1174137269 | Keiara Williams | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1699389858 | Caitlin Lauren Thomas | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1639782568 | Anna Pfouts | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585470 | Meshref Ayed Alshehri | Student in an Organized Health Care Education/Training Program | 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-07-08 |
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1740817733 | Martha Kaitlyn Coghlan | Student in an Organized Health Care Education/Training Program | Ummc Ob/gyn, 22 S. Greene St., Baltimore, MD 21201 | 2020-03-27 |
| 1629606637 | Taylor Renee Kai | Student in an Organized Health Care Education/Training Program | University of Maryland, 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-03-27 |
| 1295362697 | Brittany A Oster | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street 6th Floor, Suite 300, Baltimore, MD 21201 | 2020-03-25 |
| 1346877735 | Kayvon Michael Mobarakeh | Student in an Organized Health Care Education/Training Program | University of Maryland Department of Anesthesiology, 22 S Greene St, S11c, Baltimore, MD 21201 | 2020-03-25 |
| 1598392284 | Zachary Allan Hagen | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, 6th Flr., Suite 200, Baltimore, MD 21201 | 2020-03-24 |
| 1700430055 | Jaime Semchuk | Student in an Organized Health Care Education/Training Program | 737 West Lombard, Baltimore, MD 21201 | 2019-07-25 |
| 1952861619 | Zachary Daniel Sanford | Student in an Organized Health Care Education/Training Program | 22 S Greene Street S8b12, Baltimore, MD 21201 | 2019-03-20 |
| 1114487840 | Spencer Sykes Lovegrove | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, Sixth Floor, Suite 200, Baltimore, MD 21201 | 2019-03-20 |
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| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346361524 | Avigdor Izsak Niv | Orthopaedic Surgery | 2119 Sugarcone Rd, Baltimore, MD 21209-1027 | 2007-04-03 |
| 1891783114 | Peter R Jay | Orthopaedic Surgery | 2700 Quarry Lake Dr, Suite 300, Baltimore, MD 21209-3742 | 2005-10-11 |
| 1407297724 | John Vincent Thompson | Orthopaedic Surgery | 2401 W Belvedere Ave, Baltimore, MD 21215 | 2013-07-15 |
| 1235570839 | Pablo Wagner | Orthopaedic Surgery | 2401 W Belvedere Ave, Baltimore, MD 21215-5216 | 2013-07-11 |
| 1831471234 | St. Paul Place Specialists, Inc. | Orthopaedic Surgery | 301 Saint Paul Pl, Baltimore, MD 21202-2102 | 2011-09-13 |
| 1104007079 | Robert Paxton Mckinstry | Orthopaedic Surgery | 3333 N Calvert St, Suite 400, Baltimore, MD 21218-2867 | 2007-11-20 |
| 1346363322 | Caroline S Moazzam | Orthopaedic Surgery | 5601 Loch Raven Blvd, Smyth Bldg, Suite G-1; Jhu-department of Orthopaedics-g, Baltimore, MD 21239 | 2007-04-06 |
| 1013023647 | Orthopaedic Specialty Center | Orthopaedic Surgery | 2700 Quarry Lake Drive, Suite 300, Baltimore, MD 21209-3746 | 2006-08-23 |
| 1710913934 | Antoniades Orthopaedics, LLC | Orthopaedic Surgery | 3449 Wilkens Ave, Ste 107, Baltimore, MD 21229-5281 | 2006-06-23 |
| 1205874385 | Steve Alan Petersen | Orthopaedic Surgery | 5601 Loch Raven Blvd, Smyth Bldg, Suite G-1, Baltimore, MD 21239-2945 | 2006-06-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.