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General NPI Number Information
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NPI Number | 1306803135
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Entity Type | Individual
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Provider Name | WENDY M BONGERS MD
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Gender | Female
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 8450 SEASONS PKWY
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City | WOODBURY
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State | MN
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Zip | 55125-4402
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Country | US
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Telephone | 952-853-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 924 1ST ST NE
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City | FARIBAULT
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State | MN
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Zip | 55021-5441
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Country | US
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Telephone | 507-333-3300
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Fax | 507-333-3258
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 43477
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License Number State | MN
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