Individual
MELINDA C BONILLA-PUETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
215 W WASHINGTON STREET, GRAFTON, WI 53024
(262) 375-3700
(262) 376-6020
Mailing address
3003 W GOOD HOPE ROAD, MILWAUKEE, WI 53209
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36200
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32304700
—
WI
Enumeration date
07/09/2006
Last updated
08/27/2010
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