Individual
KUNAL N BODIWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 N FRONT ST, WORMLEYSBURG, PA 17043
(717) 731-0101
(717) 731-8359
Mailing address
409 S 2ND ST STE 2F, HARRISBURG, PA 17104-1612
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
41663
KY
207RC0000X
Cardiovascular Disease Physician
Primary
41663
KY
207RC0000X
Cardiovascular Disease Physician
MD461442
PA
207UN0901X
Nuclear Cardiology Physician
MD461442
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000
—
IL
01
—
000000545252
BLUE CROSS
KY
05
—
103315900
—
PA
05
—
7100040960
—
KY
Enumeration date
01/11/2008
Last updated
01/21/2021
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