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Individual

ALFRED LAMBERT BONJEAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
99 E 86TH AVE, STE C, MERRILLVILLE, IN 46410-6267
(219) 769-4835
(219) 769-5816
Mailing address
101 E 87TH AVE, MERRILLVILLE, IN 46410-7335
(219) 769-4835

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01024800A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000084012
ANTHEM
05
100167330
IN
Enumeration date
03/09/2006
Last updated
03/09/2015
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