Bodarya, Ketankumar
Bodarya, Ketankumar is an individual health care provider with primary practice located at 175 Kimel Park Dr Ste 100 , Winston Salem NC 27103-6951. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Bodarya, Ketankumar can be contacted via phone (336) 718-3550.Contact Information
Primary practice address
175 Kimel Park Dr Ste 100
Winston Salem NC 27103-6951
Phone: (336) 718-3550
Fax: (336) 277-1825
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 2021-00515 | North Carolina |
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | D0081182 | Maryland |
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | Ohio | |
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 2021-00515 | North Carolina |
Profile Details
NPI number | 1831496165 |
---|---|
LBN Legal business name | Bodarya, Ketankumar |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 23rd, 2011 |
Last updated | May 25th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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