Bodman, Myron A

Bodman, Myron A is an sole proprietor health care provider with primary practice located at 21245 Lorain Rd Suite 115, Fairview Park OH 44126-2140. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, which is considered as his primary health care specialty. Bodman, Myron A can be contacted via phone (440) 356-1989.

Contact Information

Primary practice address
21245 Lorain Rd Suite 115 Fairview Park OH 44126-2140
Phone: (440) 356-1989
Fax: (440) 356-5944
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X 36-00-1747 Ohio

Profile Details

NPI number 1316943970
LBN Legal business name Bodman, Myron A
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2005
Last updated Sep 17th, 2012 - about 12 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 1316943970 NPPES
Ohio MEDICAID 0360041
Ohio Other 4800325161

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