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Dr. Bonifasiyo K. Ssennyamantono, MD
Cardiovascular Disease Physician in Avondale, Arizona
NPI 1902813678

Bonifasiyo K. Ssennyamantono is a Cardiovascular Disease Physician based in Phoenix, AZ and is specialized in Cardiovascular Disease. Bonifasiyo K. Ssennyamantono practices in Avondale, AZ and has the professional credentials of MD. The NPI Number for Bonifasiyo K. Ssennyamantono is 1902813678 and holds a License No. 35788 (Arizona).

The current practice location address for Bonifasiyo K. Ssennyamantono is 10815 W Mcdowell Rd, Avondale, AZ and can be reached out via phone at 623-433-0202 and via fax at 623-433-0206.

Location: 10815 W Mcdowell Rd, Avondale, AZ, 85032-2171
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902813678
Provider Name
Bonifasiyo K. Ssennyamantono
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
10815 W Mcdowell Rd, Avondale, AZ, 85032-2171
Phone Number
623-433-0202
Fax Number
623-433-0206
Provider Enumeration Date
08/02/2006
Last Update Date
08/17/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
129134 05 AZ
institution
Provider Business Practice Location Address Details
Address
10815 W Mcdowell Rd
City
Avondale
State
Arizona
Zip
85392-5007
Phone Number
623-433-0202
Fax Number
623-433-0206
person
Provider Business Mailing Address Details
Address
10815 W Mcdowell Rd
City
Avondale
State
Arizona
Zip
85392-5007
Phone Number
623-433-0202
Fax Number
623-433-0206
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Cardiovascular Disease
Taxonomy
207RC0000X
License No.
35788 (Arizona)
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
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