Boddicker, Marc E

Boddicker, Marc E is an individual health care provider with primary practice located at 710 Saint Anne St , Rapid City SD 57701-4670. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Boddicker, Marc E can be contacted via phone (605) 343-8000.

Contact Information

Primary practice address
710 Saint Anne St Rapid City SD 57701-4670
Phone: (605) 343-8000
Fax: (605) 341-8575
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 1485 South Dakota
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X 1485 South Dakota
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 1485 South Dakota
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 1485 South Dakota

Profile Details

NPI number 1235103060
LBN Legal business name Boddicker, Marc E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2006
Last updated Mar 18th, 2016 - about 8 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 1235103060 NPPES
South Dakota Other 41192855200 NE MEDICAID
South Dakota Other 070013291 NE MEDICAID
South Dakota MEDICAID 5900162 NE MEDICAID

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