Individual
MICHAEL G BONACUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1263 HOSPITAL DR NW, SUITE 250, CORYDON, IN 47112-2172
(812) 738-8136
(812) 738-3155
Mailing address
1263 HOSPITAL DR NW, SUITE 250, CORYDON, IN 47112-2172
(812) 738-8136
(812) 738-3155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02001396
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200008150
—
IN
Enumeration date
06/02/2005
Last updated
07/18/2022
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