Organization Name: | BONNER EMERGENCY MEDICINE ASSOCIATES PA |
NPI Number: | 1841469244 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL A. PAWLOWSKI (PRESIDENT) |
Mailing Address: | 1325 N Dickinson Dr Rusk |
State: | TX US |
Postal Code: | 757851051 |
Phone Number: | 9036833601 |
Fax Number: | |
NPI Enumeration Date: | 02/29/2008 |
NPI Last Update Date: | 02/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |