Individual
SUZANNAH BONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
W180N8085 TOWN HALL RD, CMH HEART AND VASCULAR CENTER, MENOMONEE FALLS, WI 53051-3518
(262) 532-1300
Mailing address
W180N8085 TOWN HALL RD, CMH HEART AND VASCULAR CENTER, MENOMONEE FALLS, WI 53051-3518
(262) 532-1300
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780704510
—
WI
05
—
41939700
—
WI
Enumeration date
03/29/2007
Last updated
10/02/2018
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