Bodurtha, Joann N
Bodurtha, Joann N is an individual health care provider with primary practice located at 600 N Wolfe St Blalock 1012 D Medical Genetics, Baltimore MD 21287-0005. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) is her primary health care specialty. Bodurtha, Joann N can be contacted via phone (410) 955-1699.Contact Information
Primary practice address
600 N Wolfe St Blalock 1012 D Medical Genetics
Baltimore MD 21287-0005
Phone: (410) 955-1699
Fax: (410) 614-9246
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | 0101036738 | Virginia |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0101036738 | Virginia |
| Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | D73075 | Maryland |
Profile Details
| NPI number | 1336225028 |
|---|---|
| LBN Legal business name | Bodurtha, Joann N |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2006 |
| Last updated | Dec 10th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336225028 | NPPES |
| Virginia | MEDICAID | 6756964 | |
| Virginia | MEDICAID | 049028800 |
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