MEDICARE: DR. DAVID BONHEIM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	29087	CT

General Provider Information

NPI Number	:	1083679351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID BONHEIM M.D.

Provider Business Mailing Address
First Line	:	132 MONROE TPKE
Second Line	:
City	:	TRUMBULL
State	:	CT
Zip	:	06611-1341
Country	:	US
Telephone Number	:	203-268-1766
Fax Number	:	203-268-0787

Provider Business Practice Location Address
First Line	:	132 MONROE TPKE
Second Line	:
City	:	TRUMBULL
State	:	CT
Zip	:	06611-1341
Country	:	US
Telephone Number	:	203-268-1766
Fax Number	:	203-268-0787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. DAVID BONHEIM M.D.” Practice Location

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