Individual
JAMES E. BODOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
44932
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-00293
MEDICA
MN
01
—
27G29BO
BCBS MN FACILITY
MN
05
—
43282000
—
WI
01
—
64Q23BO
BCBS MN PRO FEE
MN
05
—
843042000
—
MN
01
—
HP10148
HEALTHPARTNERS
MN
01
—
NA9031006543
PREFERRED ONE
MN
Enumeration date
10/24/2006
Last updated
09/06/2012
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