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Ms. Bonnie Merritt Wallace, PA-C
Physician Assistant in Portage, Michigan
NPI 1437402229

Bonnie Merritt Wallace is a Physician Assistant based in Portage, MI. Bonnie Merritt Wallace practices in Portage, MI and has the professional credentials of PA-C. The NPI Number for Bonnie Merritt Wallace is 1437402229 and holds a License No. 5601006513 (Michigan).

The current practice location address for Bonnie Merritt Wallace is 3304 Cooley Ct, Portage, MI and can be reached out via phone at 269-349-2266 and via fax at 269-349-0792.

Location: 3304 Cooley Ct, Portage, MI, 49024-7430
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1437402229
Provider Name
Bonnie Merritt Wallace
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
3304 Cooley Ct, Portage, MI, 49024-7430
Phone Number
269-349-2266
Fax Number
269-349-0792
Provider Enumeration Date
10/18/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1437402229 05 MI
5601006513 01 MI PHYSICIAN'S ASSISTANT LICENSE
1417961137 01 MI BCBSM - BMH
institution
Provider Business Practice Location Address Details
Address
3304 Cooley Ct
City
Portage
State
Michigan
Zip
49024-7430
Phone Number
269-349-2266
Fax Number
269-349-0792
person
Provider Business Mailing Address Details
Address
3304 Cooley Ct
City
Portage
State
Michigan
Zip
49024-7430
Phone Number
269-349-2266
Fax Number
269-349-0792
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
-
Taxonomy
363A00000X
License No.
5601006513 (Michigan)
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 perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
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