Individual
DR. ERNEST J BONITATIBUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL PARK, WHEELING, WV 26003-6379
(304) 243-3124
(304) 243-6343
Mailing address
9 KENWOOD PL, WHEELING, WV 26003-6042
(304) 243-1027
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
10790
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050401000
—
WV
Enumeration date
05/17/2006
Last updated
06/09/2011
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