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Individual
JAYESH BHARAT BODALIA
Active
Individual
JAYESH BHARAT BODALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
004917
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206121990A
—
GA
01
—
CK6241
MEDICARE RAILROAD
GA
Enumeration date
02/09/2007
Last updated
01/16/2016
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