Individual
DR. BONNIE E NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1106 E PROSPECT RD, SUITE 100, FORT COLLINS, CO 80525-5306
(970) 495-7410
(970) 495-7425
Mailing address
1106 E PROSPECT RD, SUITE 100, FORT COLLINS, CO 80525-5306
(970) 495-7410
(970) 495-7425
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
49398
CO
207R00000X
Internal Medicine Physician
5464
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133241400
—
WY
05
—
6004840
—
SD
05
—
82955379
—
CO
Enumeration date
08/03/2005
Last updated
12/21/2015
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