Individual
NIDA E BONUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2825 SIENA HEIGHTS DR STE 101, HENDERSON, NV 89052-5488
(702) 616-7049
(702) 492-1467
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
7502
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760440200
—
NV
01
—
7502
STATE LICENSE
NV
01
—
P00367728
RAIL ROAD MEDICARE
NV
Enumeration date
05/03/2006
Last updated
10/17/2022
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