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Individual

JOHAN HENDRIK LEONARD BONESCHANSKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3068
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
282680
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110116193A
MA
Enumeration date
05/10/2016
Last updated
12/08/2023
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