Bonaventura, Leo M.

Bonaventura, Leo M. is an individual health care provider with primary practice located at 4199 Gateway Blvd Suite 2900, Newburgh IN 47630-8940. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Reproductive Endocrinology. Allopathic & Osteopathic Physicians / Reproductive Endocrinology is his primary health care specialty. Bonaventura, Leo M. can be contacted via phone (812) 842-4530.

Contact Information

Primary practice address
4199 Gateway Blvd Suite 2900 Newburgh IN 47630-8940
Phone: (812) 842-4530
Fax: (812) 842-4535
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 01022970 Indiana
Allopathic & Osteopathic Physicians / Reproductive Endocrinology 207VE0102X 01022970 Indiana

Profile Details

NPI number 1962419085
LBN Legal business name Bonaventura, Leo M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Jan 25th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962419085 NPPES
Indiana Other 000000328110 ANTHEM
Indiana Other 000000580355 ANTHEM

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