Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | MD030759E | PA |
NPI | 1184696940 |
---|---|
Provider Name | Dr. Marguerite A Bonaventura |
First Address | Pittsburgh, PA 15213-3108 |
Second Address | Pittsburgh, PA 15213-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 01/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001127800 | (05) | PA |
D68765 | (02) | PA |