Bonisa, Michael Robert

Bonisa, Michael Robert is an individual health care provider with primary practice located at 3623 Latrobe Dr Suite 216, Charlotte NC 28211. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Bonisa, Michael Robert can be contacted via phone (704) 332-1291.

Contact Information

Primary practice address
3623 Latrobe Dr Suite 216 Charlotte NC 28211
Phone: (704) 332-1291
Fax: (704) 332-5206
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 000102829 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 000102829 North Carolina

Profile Details

NPI number 1760444723
LBN Legal business name Bonisa, Michael Robert
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Feb 3rd, 2023 - about 3 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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