| Vincent Anthony Bonanno, MD | |
| 
					4881 Sugar Maple Dr, Wpafb, OH 45433-5546  | |
| (937) 257-9926 | |
| (937) 257-1529 | 
| Full Name | Vincent Anthony Bonanno | 
|---|---|
| Gender | Male | 
| Speciality | Internal Medicine | 
| Location | 4881 Sugar Maple Dr, Wpafb, Ohio | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1447225735 | NPI | - | NPPES | 
| 2304689 | Medicaid | OH | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | 35079926 (Ohio) | Primary | 
| Entity Name | Five Rivers Health Centers | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1104115823 PECOS PAC ID: 9335300904 Enrollment ID: O20120409000638  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Vincent Anthony Bonanno, MD 4881 Sugar Maple Dr, Wpafb, OH 45433-5546 Ph: (937) 257-9926  | Vincent Anthony Bonanno, MD 4881 Sugar Maple Dr, Wpafb, OH 45433-5546 Ph: (937) 257-9926  | 
John Alan Arthur,  Internal Medicine Medicare: Medicare Enrolled Practice Location: 4881 Sugar Maple Dr, Wpafb, OH 45433 Phone: 937-257-4482  | |
Dr. Sneh L Patwa, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2325 Fifth Street, Wpafb, OH 45433 Phone: 937-904-8385  | |
Gregory D. Carbonella, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 4881 Sugar Maple Dr, Wpafb, OH 45433 Phone: 937-713-6567  | |
Dr. Daniel Vernon Foster, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 88 Mdg/sghj, 4881 Sugar Maple Drive, Wpafb, OH 45433 Phone: 937-257-1591 Fax: 937-656-1128  | |
Dr. Dara Daniela Regn, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 88 Medical Group, 4881 Sugar Maple Dr, Wpafb, OH 45433 Phone: 937-257-7218  | |
Dr. Alicia Marie Latta, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 4881 Sugar Maple Dr, Wpafb, OH 45433 Phone: 937-208-2004  | |
Ian Michael Delvalle, DO Internal Medicine Medicare: Medicare Enrolled Practice Location: 88th Medical Group, 4881 Sugar Maple Dr., Wpafb, OH 45305 Phone: 937-257-0837  |