Individual
DR. AMANDA MICHELLE BONVICINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 PARK CENTRAL DR, HIGHLANDS RANCH, CO 80129-6688
(720) 848-0000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
CDRH.0056687
CO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
M8544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DR0056687
MEDICAL LICENSE
CO
Enumeration date
08/21/2007
Last updated
03/24/2021
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