Individual
DR. GEORGE FRED BONADURER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
22333
WI
207N00000X
Dermatology Physician
67465
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099778
—
WI
Enumeration date
03/20/2018
Last updated
02/02/2023
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