Louis B Bonita, M.D.

Individual provider Active NPI Family Medicine Physician · West Wyoming, PA

NPI 1144479296 · NPPES record last updated Sep 13, 2008

Key facts

NPI
1144479296
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
MD0164943 (PA)
Practice address
527 Shoemaker Ave
West Wyoming, PA 18644-1212
Phone
(570) 693-2760
NPI assigned
Sep 13, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0164943PAMDFamily Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD0164943 PA Yes

Addresses

Primary practice location

527 Shoemaker Ave
West Wyoming, PA 18644-1212

Mailing address

527 Shoemaker Ave
West Wyoming, PA 18644-1212
Phone (570) 693-2760

Other names

  • Dr. Louis B Bonita Professional name

Other providers in West Wyoming, PA

All providers in West Wyoming, PA · Family Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.