Individual
ANNA MARY BONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-0000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01082040A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001272014
ANTHEM PTAN
IN
01
—
000001273746
ANTHEM PTAN
IN
01
—
000001273758
ANTHEM PTAN
IN
01
—
000001273759
ANTHEM PTAN
IN
05
—
300025646
—
IN
Enumeration date
04/13/2016
Last updated
03/16/2025
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