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Individual
STEPHEN M BODJANAC
Active
Individual
STEPHEN M BODJANAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34006963
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023301025
PRACTICE TYPE 2 NPI #
OH
01
—
1841239274
PPG GROUP NPI #
OH
05
—
2127657
—
OH
01
—
2551671
MEDICAID GROUP #
OH
01
—
9338635
MEDICARE GROUP #
OH
01
—
P00469259
RAILROAD MEDICARE #
OH
Enumeration date
03/23/2006
Last updated
07/01/2011
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