Bodek, Kenneth Edward
Bodek, Kenneth Edward is an individual health care provider with primary practice located at 186 Kimel Park Dr Suite 400, Winston Salem NC 27103-6946. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Nuclear Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Bodek, Kenneth Edward can be contacted via phone (336) 277-2000.Contact Information
Primary practice address
186 Kimel Park Dr Suite 400
Winston Salem NC 27103-6946
Phone: (336) 277-2000
Fax: (336) 277-2050
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 2013-01642 | North Carolina |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | MD046703L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Nuclear Cardiology | 207UN0901X | MD046703L | Pennsylvania |
Profile Details
| NPI number | 1871587923 |
|---|---|
| LBN Legal business name | Bodek, Kenneth Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2005 |
| Last updated | Nov 15th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871587923 | NPPES |
| Pennsylvania | Other | 024733E15 | MEDICARE |
| Pennsylvania | MEDICAID | 0012804190005 | MEDICARE |
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