Bonaventura, Leo M.
Bonaventura, Leo M. is an individual health care provider with primary practice located at 4199 Gateway Blvd Suite 2900, Newburgh IN 47630-8940. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Reproductive Endocrinology. Allopathic & Osteopathic Physicians / Reproductive Endocrinology is his primary health care specialty. Bonaventura, Leo M. can be contacted via phone (812) 842-4530.Contact Information
Primary practice address
4199 Gateway Blvd Suite 2900
Newburgh IN 47630-8940
Phone: (812) 842-4530
Fax: (812) 842-4535
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 01022970 | Indiana |
| Allopathic & Osteopathic Physicians / Reproductive Endocrinology | 207VE0102X | 01022970 | Indiana |
Profile Details
| NPI number | 1962419085 |
|---|---|
| LBN Legal business name | Bonaventura, Leo M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2006 |
| Last updated | Jan 25th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962419085 | NPPES |
| Indiana | Other | 000000328110 | ANTHEM |
| Indiana | Other | 000000580355 | ANTHEM |
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