Boddicker, Kimberly Anne

Boddicker, Kimberly Anne is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Boddicker, Kimberly Anne can be contacted via phone (218) 786-3443.

Contact Information

Primary practice address
400 E 3Rd St Duluth MN 55805-1951
Phone: (218) 786-3443
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 47894-20 Wisconsin
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 16931 North Dakota
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 47480 Minnesota

Profile Details

NPI number 1821037946
LBN Legal business name Boddicker, Kimberly Anne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Dec 9th, 2020 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1821037946 NPPES
Minnesota MEDICAID 933138700

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