Individual
BONNIE A MCMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
61 MAPLE RD, WILLIAMSVILLE, NY 14221-2918
(716) 565-1234
(716) 565-1246
Mailing address
61 MAPLE RD, WILLIAMSVILLE, NY 14221-2918
(716) 565-1234
(716) 565-1246
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
191409
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010115603
UNIVERA/EXCELLUS
NY
01
—
000523966004
BCBS OF WNY
NY
05
—
01843145
—
NY
01
—
0407784
IHA
NY
Enumeration date
07/11/2005
Last updated
01/31/2018
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