Individual
DR. AMY M BONIFAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6000 EARLE BROWN DR, BROOKLYN CENTER, MN 55430-2506
(952) 993-4900
Mailing address
8170 33RD AVE S, PO BOX 1309 MAIL STOP 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41580
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
548015900
—
MN
Enumeration date
12/29/2005
Last updated
03/08/2016
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