Individual
ALYSSA BONTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3533 SOUTHERN BLVD STE 2200, DAYTON, OH 45429-1264
(937) 228-4126
(937) 424-8659
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8493
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
35.122523
OH
2086S0129X
Vascular Surgery Physician
Primary
35.122523
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0279347
—
OH
01
—
H618980
MEDICARE
—
Enumeration date
04/13/2011
Last updated
08/13/2024
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