Dr. Fredric L Bonine
Oral and Maxillofacial Pathology
6893 Grand River Rd
Brighton
, Michigan 48114-9345
Dr. Fredric L Bonine
Oral and Maxillofacial Pathology
6893 Grand River Rd
Brighton
, Michigan 48114-9345
(810) 229-1880
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. Fredric L Bonine
- 6893 Grand River Rd
- Brighton, MI
- Zip : 48114-9345
- Fax : (810) 229-1880
- Phone : (810) 229-9180
Second Address
- Dr. Fredric L Bonine
- 6893 Grand River Rd
- Brighton, MI
- Zip : 48114-9345
- Fax : (810) 229-1880
- Phone : (810) 229-9180
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 2910112106 | MI |
National Provider Identifier
| NPI | 1063440543 |
|---|---|
| Provider Name | Dr. Fredric L Bonine |
| First Address | Brighton, MI 48114-9345 |
| Second Address | Brighton, MI 48114-9345 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/06/2006 |
| Last Update Date | 22/05/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1184980914 | SOLE PROPRIETOR NPI (01) | MI |
| T82797 | (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.