Bonner, Michael G

Bonner, Michael G is an individual health care provider with primary practice located at 435 River Ave , Williamsport PA 17701-3722. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bonner, Michael G can be contacted via phone (570) 326-8070.

Contact Information

Primary practice address
435 River Ave Williamsport PA 17701-3722
Phone: (570) 326-8070
Fax: (570) 326-0396
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OEG000810 Pennsylvania

Profile Details

NPI number 1407881501
LBN Legal business name Bonner, Michael G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jan 7th, 2021 - about 5 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 1407881501 NPPES
Other 50099291 CAPITAL BLUE CROSS
Other 2027189 CAPITAL BLUE CROSS
Other P00943504 CAPITAL BLUE CROSS
MEDICAID 1012670710001 CAPITAL BLUE CROSS

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