Bruce A. Bolonesi in Salt Lake City - Physician Assistant
Bruce A. Bolonesi - NPI 1619928199
Bruce A. Bolonesi is a Physician Assistant in Salt Lake City, Utah. Bruce A. Bolonesi practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Bruce A. Bolonesi is 1619928199. The last update date is 2011-10-17.
Bruce A. Bolonesi's current location address is 1121 E 3900 S, Salt Lake City, Utah. You can contact this provider via phone number 8012633416. The mailing address for Bruce A. Bolonesi is 1121 E 3900 S, Salt Lake City, Utah. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bruce A. Bolonesi |
|---|---|
| Address | 1121 E 3900 S, Salt Lake City, Utah |
| Phone Number | 8012633416 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1619928199 |
|---|---|
| Provider Enumeration Date | 2006-05-12 |
| Last Updated Date | 2011-10-17 |
Provider Mailing Address Detail
| Address | 1121 E 3900 S |
|---|---|
| City | Salt Lake City |
| State | Utah (UT) |
| Post Code | 841241214 |
| Phone Number | 8012633416 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 106591-1206 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 270286 | UT | ALTIUS |
Post Comment/ Review Below
Could you provide the complete address where Bruce A. Bolonesi is physically located?
The Bruce A. Bolonesi is situated at the following address: 1121 E 3900 S, Salt Lake City, UT 841241214.
Could you please share the complete physical location address where Bruce A. Bolonesi's facilities are situated?
The facilities of Bruce A. Bolonesi are physically located at the following address: 1121 E 3900 S, Salt Lake City, UT, 841241214.
On what date was the 1619928199 assigned to Bruce A. Bolonesi?
The Bruce A. Bolonesi was issued its 1619928199 on 2006-05-12, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
On what date did the Bruce A. Bolonesi receive the assignment of its 1619928199 from the Centers for Medicare & Medicaid Services?
The Bruce A. Bolonesi was issued its 1619928199 by the Centers for Medicare & Medicaid Services on 2006-05-12.
When was the information regarding Bruce A. Bolonesi most recently updated?
The details pertaining to the Bruce A. Bolonesi, including its address, specialty, and other relevant information, were last refreshed on 2011-10-17.
NPI Number: 1528061710
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