Individual
DR. MARTIN D BONNEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 W SMITH VALLEY RD STE C1, GREENWOOD, IN 46142-1589
(317) 300-4091
Mailing address
1700 W SMITH VALLEY RD STE C1, GREENWOOD, IN 46142-1589
(317) 300-4091
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01047187A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000060164
BCBS OF KY 12 DIGIT #
KY
01
—
000000275811
BCBS OF KY 12 DIGIT #
KY
01
—
50004094
PASSPORT GROUP # 50000548
KY
01
—
50004275
PASSPORT GROUP # 1172544
KY
05
—
64040843
—
KY
Enumeration date
06/14/2005
Last updated
07/23/2021
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