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Individual

JAMES E. BODOH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2037
Mailing address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2037

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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