Individual
MICHAEL J BONITATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-6829
Mailing address
825 CHALKSTONE AVE, PROVIDENCE, RI 02908-4728
(401) 456-6829
(401) 456-2120
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD07667
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7001165
—
RI
Enumeration date
02/08/2007
Last updated
04/09/2013
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