Bodison, Dan Robert

Bodison, Dan Robert is an individual health care provider with primary practice located at 4605 Monticello Rd Eau Claire Cooperative Health Center, Columbia SC 29203-4156. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bodison, Dan Robert can be contacted via phone (803) 252-7001.

Contact Information

Primary practice address
4605 Monticello Rd Eau Claire Cooperative Health Center Columbia SC 29203-4156
Phone: (803) 252-7001
Fax: (803) 252-5219
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 19113 South Carolina

Profile Details

NPI number 1215937610
LBN Legal business name Bodison, Dan Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2005
Last updated Jun 3rd, 2011 - about 13 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 1215937610 NPPES
South Carolina MEDICAID 119134

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