Individual
DR. JAMES S. BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1354 RUSTICVIEW DR, BALLWIN, MO 63011-4271
(314) 691-7488
Mailing address
1354 RUSTICVIEW DR, BALLWIN, MO 63011-4271
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
36152
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201585841
—
MO
Enumeration date
12/28/2005
Last updated
10/26/2010
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