Engelbart, Bonnie
Engelbart, Bonnie is an individual health care provider with primary practice located at 454 Broadway , Revere MA 01901. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Engelbart, Bonnie can be contacted via phone (781) 485-8222.Contact Information
Primary practice address
454 Broadway
Revere MA 01901
Phone: (781) 485-8222
Fax: (781) 485-8220
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 215224 | Massachusetts |
Profile Details
| NPI number | 1558464578 |
|---|---|
| LBN Legal business name | Engelbart, Bonnie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2006 |
| Last updated | Feb 29th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558464578 | NPPES |
| Massachusetts | MEDICAID | 2148960 |
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