Individual
BONNIE ENGELBART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
454 BROADWAY, REVERE, MA 01901
(781) 485-8222
(781) 485-8220
Mailing address
454 BROADWAY, REVERE, MA 01901
(781) 485-8222
(781) 485-8220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
215224
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2148960
—
MA
Enumeration date
09/06/2006
Last updated
02/29/2012
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