NPI 1003590027

Abram Richard Bonneville, PAS

Practitioner Physician Assistant Manitowoc, WI

Practice location

Address: 1409 Hazelwood Dr, Manitowoc, WI 54220-1607
Phone: (608) 843-6117

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 7426 (WI)

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Registry record

NPI: 1003590027
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Jun 2023
Record last updated: 28 Jul 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.