Individual
DR. BONNIE LEE WIRFS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 DOMANIK DRIVE, RACINE, WI 53404
(262) 633-0500
(262) 633-3045
Mailing address
2000 DOMANIK DRIVE, RACINE, WI 53404
(262) 633-0500
(262) 633-3045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27907
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27907
WISCONSIN STATE LICENSE #
—
05
—
30779200
—
WI
Enumeration date
12/05/2006
Last updated
03/07/2023
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