Bonner, Bethann

Bonner, Bethann is an individual health care provider with primary practice located at 1500 Associates Dr , Dubuque IA 52002-2201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bonner, Bethann can be contacted via phone (563) 584-4440.

Contact Information

Primary practice address
1500 Associates Dr Dubuque IA 52002-2201
Phone: (563) 584-4440
Fax: (563) 584-4295
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 29141 Iowa
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25904 Wisconsin

Profile Details

NPI number 1811946320
LBN Legal business name Bonner, Bethann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Nov 25th, 2009 - about 16 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 1811946320 NPPES
Iowa MEDICAID 0094193

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