Bonner, Michael G
Bonner, Michael G is an individual health care provider with primary practice located at 435 River Ave , Williamsport PA 17701-3722. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bonner, Michael G can be contacted via phone (570) 326-8070.Contact Information
Primary practice address
435 River Ave
Williamsport PA 17701-3722
Phone: (570) 326-8070
Fax: (570) 326-0396
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OEG000810 | Pennsylvania |
Profile Details
| NPI number | 1407881501 |
|---|---|
| LBN Legal business name | Bonner, Michael G |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Jan 7th, 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 | 1407881501 | NPPES |
| Other | 50099291 | CAPITAL BLUE CROSS | |
| Other | 2027189 | CAPITAL BLUE CROSS | |
| Other | P00943504 | CAPITAL BLUE CROSS | |
| MEDICAID | 1012670710001 | CAPITAL BLUE CROSS |
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