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Contact Information

MICHAEL R BONISA, PA-C
3623 LATROBE DR
SUITE 216
CHARLOTTE, NC28211
 Phone: 704-332-1291
 Fax: 704-332-5206
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for MICHAEL R BONISA · (Male)

NPI # 1760444723
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 04/05/2006
Last updated 02/03/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 000102829
Hospital affiliation(s)
  • PRESBYTERIAN HOSPITAL - (Acute Care)
    200 HAWTHORNE LANE BOX 33549
    CHARLOTTE, NC 28233
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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