Brockman, Bonita L
Brockman, Bonita L is an individual health care provider with primary practice located at 2041 Mesa Valley Way Ste 185, Austell GA 30106. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Brockman, Bonita L can be contacted via phone (404) 785-8900.Contact Information
Primary practice address
2041 Mesa Valley Way Ste 185
Austell GA 30106
Phone: (404) 785-8900
Fax: (404) 785-8948
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 045410 | Georgia |
Profile Details
| NPI number | 1962443515 |
|---|---|
| LBN Legal business name | Brockman, Bonita L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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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