Individual
MR. SCOTT C BONZHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4272 W VIENNA RD, CLIO, MI 48420-9454
(810) 919-9415
(810) 686-1687
Mailing address
PO BOX 685, LAPEER, MI 48446
(866) 898-7139
(616) 975-9827
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
SB002841
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SB002841
BCBS
MI
Enumeration date
05/23/2006
Last updated
02/04/2021
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