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Individual
MARK GORDON BODDY
Active
Individual
MARK GORDON BODDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
G89220
CA
207VM0101X
Maternal & Fetal Medicine Physician
032519
GA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
G89220
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00609221C
—
GA
Enumeration date
09/28/2006
Last updated
04/19/2024
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