Individual
MR. JUAN MIGUEL BONETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
113 LINER DR, GREENWOOD, SC 29646-2311
(864) 941-8170
(864) 388-1718
Mailing address
313 MAIN ST, SUITE B, GREENWOOD, SC 29646-2757
(864) 388-0301
(864) 388-0648
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
16583
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165831
—
SC
Enumeration date
05/31/2005
Last updated
09/18/2013
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