Individual provider · NPI-1

Ryan Bonek, M.D.

Family Medicine · Mishawaka, IN

NPI number1730523846
StatusActive
Last updated in NPPESMar 30, 2021

Details

NPI
1730523846
Entity type
Individual (NPI-1)
Name
Ryan Bonek
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Apr 18, 2013
Certification date
Mar 30, 2021
Last updated
Mar 30, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine01077161AINYes

Practice location

4630 Vistula Rd
Mishawaka, IN 46544-4000

Phone 574-647-1900 · Fax 574-647-7206

Mailing address

710 N Niles Ave
South Bend, IN 46617-1924

Phone 574-647-1610 · Fax 574-237-6069

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