Individual
DR. MARIE ROSE BONABON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
309 W BUTLER RD, MAULDIN, SC 29662-2531
(864) 297-1575
(864) 284-0844
Mailing address
800 PELHAM RD, GREENVILLE, SC 29615-3300
(864) 234-5800
(864) 284-0844
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23996
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
239969
—
SC
Enumeration date
03/23/2006
Last updated
07/08/2007
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