Individual
DR. JAMES MICHAEL BONANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
142 BERKELEY ST, BOSTON, MA 02116-5100
(617) 267-0900
(617) 247-3460
Mailing address
142 BERKELEY ST, BOSTON, MA 02116-5100
(617) 267-0900
(617) 247-3460
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
74689
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OJ 11647
—
MA
Enumeration date
01/13/2006
Last updated
01/26/2012
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