Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD064975L | PA |
NPI | 1912915786 |
---|---|
Provider Name | Michael Bonidie |
First Address | Pittsburgh, PA 15213-2536 |
Second Address | Pittsburgh, PA 15213-3108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G30609 | (02) | PA |