Healthcare Provider Details

I. General information

NPI: 1790761823
Provider Name (Legal Business Name): ARTURO JOSE BONNIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8039 WASHINGTON VILLAGE DRIVE SUITE #100
CENTERVILLE OH
45458-3859
US

IV. Provider business mailing address

8039 WASHINGTON VILLAGE DRIVE SUITE #100
CENTERVILLE OH
45458
US

V. Phone/Fax

Practice location:
  • Phone: 937-435-8999
  • Fax: 937-435-4211
Mailing address:
  • Phone: 937-435-8999
  • Fax: 937-435-4211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number35 063692
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: