Individual
TYLER JOHN BONKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
22060 BEECH ST STE 200, DEARBORN, MI 48124-2853
(313) 228-0505
Mailing address
25 MICHIGAN ST NE STE 2100, GRAND RAPIDS, MI 49503-2526
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5151014105
MI
207RC0000X
Cardiovascular Disease Physician
Primary
5101026290
MI
Other
Enumeration date
07/02/2019
Last updated
06/20/2022
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