Individual
DR. BEVAN P BONHOMME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
(860) 609-9929
(919) 966-3049
Mailing address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
(860) 609-9929
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
76463
CT
390200000X
Student in an Organized Health Care Education/Training Program
260786
NC
Other
Enumeration date
05/02/2020
Last updated
11/17/2023
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