Individual
COMFORT BONU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
455 SAINT MICHAELS DR, ST. VINCENT HOSPITALIST GROUP, SANTA FE, NM 87505-7601
(505) 989-6130
(505) 820-5408
Mailing address
455 SAINT MICHAELS DR, PHYSICIAN PRACTICES, SANTA FE, NM 87505-7601
(505) 989-6130
(505) 820-5408
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2010-0050
NM
208000000X
Pediatrics Physician
01049085A
IN
208000000X
Pediatrics Physician
MD2010-0050
NM
208M00000X
Hospitalist Physician
Primary
MD2010-0050
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200200060
—
IN
Enumeration date
02/03/2006
Last updated
01/23/2015
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