Daniel L Bonifacio
Internist - Cardiovascular Disease
1200 Sixth St Suite 200
Traverse City
, Michigan 49684-2369
Daniel L Bonifacio
Internist - Cardiovascular Disease
1200 Sixth St Suite 200
Traverse City
, Michigan 49684-2369
(231) 935-6081
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About
Features
Specialties
- Internist - Cardiovascular Disease
Languages spoken
- English
Location
First Address
- Daniel L Bonifacio
- 2891 Momentum Pl
- Chicago, IL
- Zip : 60689-5328
- Fax : (231) 935-6081
- Phone : (231) 935-6080
Second Address
- Daniel L Bonifacio
- 1200 Sixth St Suite 200
- Traverse City, MI
- Zip : 49684-2369
- Fax : (231) 935-5799
- Phone : (231) 935-5800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0000X | Internist - Cardiovascular Disease | 5101011505 | MI |
National Provider Identifier
| NPI | 1033104880 |
|---|---|
| Provider Name | Daniel L Bonifacio |
| First Address | Chicago, IL 60689-5328 |
| Second Address | Traverse City, MI 49684-2369 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/09/2005 |
| Last Update Date | 17/05/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 4204742 | (05) | MI |
| G95950 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.