Individual
THEODORE BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8200 W SILVER SPRING DR, MILWAUKEE, WI 53218-2552
(414) 760-3900
Mailing address
2555 N MARTIN LUTHER KING DR, MILWAUKEE, WI 53212-2709
(414) 372-8080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29912
WI
207R00000X
Internal Medicine Physician
29912
WI
Other
Enumeration date
01/04/2007
Last updated
03/07/2023
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