Provider Demographics
NPI:1891764262
Name:BONNELL, SANEE M (MD)
Entity Type:Individual
Prefix:
First Name:SANEE
Middle Name:M
Last Name:BONNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-2515
Mailing Address - Country:US
Mailing Address - Phone:608-835-6973
Mailing Address - Fax:
Practice Address - Street 1:6200 KNOLLWOOD DR
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575-2515
Practice Address - Country:US
Practice Address - Phone:608-835-6973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI28215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine