Individual
DR. LANDY E BONELLI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-7299
(414) 649-6694
Mailing address
7071 S 13TH ST, STE 104, OAK CREEK, WI 53154-1466
(414) 570-7106
(414) 570-7136
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
19657-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30172900
—
WI
Enumeration date
05/04/2006
Last updated
07/08/2007
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