Individual
CHARLES STEPHEN BONNEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
503 N MAIN ST, SUITE 640, PUEBLO, CO 81003-3130
(719) 542-6000
(719) 542-6037
Mailing address
503 N MAIN ST, SUITE 640, PUEBLO, CO 81003-3130
(719) 542-6000
(719) 542-6037
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
19099
CO
2084P0800X
Psychiatry Physician
2390A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01190990
—
CO
Enumeration date
04/14/2006
Last updated
07/08/2007
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