Bonanni, Marc A
Bonanni, Marc A is an individual health care provider with primary practice located at 524 Byron Rd , Howell MI 48843-1410. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Bonanni, Marc A can be contacted via phone (517) 548-3100.Contact Information
Primary practice address
524 Byron Rd
Howell MI 48843-1410
Phone: (517) 548-3100
Fax: (517) 548-4594
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 5901001940 | Michigan |
Profile Details
| NPI number | 1780645192 |
|---|---|
| LBN Legal business name | Bonanni, Marc A |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 28th, 2006 |
| Last updated | Jun 15th, 2021 - about 3 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 | 1780645192 | NPPES |
| Michigan | MEDICAID | 4144617 | |
| Michigan | MEDICAID | 4134728 | |
| Michigan | Other | 4858215680 |
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