Provider Demographics
NPI:1790761823
Name:BONNIN, ARTURO JOSE (MD)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:JOSE
Last Name:BONNIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8039 WASHINGTON VILLAGE DRIVE
Mailing Address - Street 2:SUITE #100
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458
Mailing Address - Country:US
Mailing Address - Phone:937-435-8999
Mailing Address - Fax:937-435-4211
Practice Address - Street 1:8039 WASHINGTON VILLAGE DRIVE
Practice Address - Street 2:SUITE #100
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-3859
Practice Address - Country:US
Practice Address - Phone:937-435-8999
Practice Address - Fax:937-435-4211
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 063692207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0893476Medicaid
OH9289194Medicare PIN
OH0893476Medicaid
OH9289196Medicare PIN
OH9289197Medicare PIN