Individual
BETHANN BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 ASSOCIATES DR, DUBUQUE, IA 52002-2201
(563) 584-4440
(563) 584-4295
Mailing address
1500 ASSOCIATES DR, DUBUQUE, IA 52002-2201
(563) 584-4100
(563) 584-4110
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25904
WI
208000000X
Pediatrics Physician
Primary
29141
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0094193
—
IA
Enumeration date
05/10/2006
Last updated
11/25/2009
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