Individual
GREGORY J. BONAVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 6TH ST SW, SUITE A2-710, CANTON, OH 44710-1702
(440) 454-8076
(330) 454-3927
Mailing address
2600 6TH ST SW, SUITE A2-710, CANTON, OH 44710-1702
(440) 454-8076
(330) 454-3927
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35-06-7797
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128883
—
OH
Enumeration date
01/10/2006
Last updated
04/17/2008
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