Individual
BONNIE M SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8201 MISH KO SWEN DR, CRANDON, WI 54520-8631
(715) 478-4300
Mailing address
3000 WESTHILL DR, SUITE 303, WAUSAU, WI 54401-3795
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
43356
WI
207Q00000X
Family Medicine Physician
Primary
43356
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34087600
—
WI
Enumeration date
07/05/2006
Last updated
03/21/2022
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