Bong, Suzannah

Bong, Suzannah is an individual health care provider with primary practice located at W180N8085 Town Hall Rd Cmh Heart And Vascular Center, Menomonee Falls WI 53051-3518. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Bong, Suzannah can be contacted via phone (262) 532-1300.

Contact Information

Primary practice address
W180N8085 Town Hall Rd Cmh Heart And Vascular Center Menomonee Falls WI 53051-3518
Phone: (262) 532-1300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X

Profile Details

NPI number 1780704510
LBN Legal business name Bong, Suzannah
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2007
Last updated Oct 2nd, 2018 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780704510 NPPES
Wisconsin MEDICAID 1780704510
Wisconsin MEDICAID 41939700

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