Esdale, Amy Bonner
Esdale, Amy Bonner is an individual health care provider with primary practice located at 298 Washington St , Gloucester MA 01930-4832. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Esdale, Amy Bonner can be contacted via phone (978) 283-2726.Contact Information
Primary practice address
298 Washington St
Gloucester MA 01930-4832
Phone: (978) 283-2726
Fax: (978) 283-0840
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 78116 | Massachusetts |
Profile Details
| NPI number | 1538256532 |
|---|---|
| LBN Legal business name | Esdale, Amy Bonner |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Jan 20th, 2012 - about 12 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 | 1538256532 | NPPES |
| Massachusetts | MEDICAID | 6191045 |
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