Individual
VIPUL BODAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 SAN PEDRO DR SE # 2C-100, ALBUQUERQUE, NM 87108-5180
(505) 272-3120
(505) 265-1711
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
65444-20
WI
207R00000X
Internal Medicine Physician
Primary
MD2016-0585
NM
2083C0008X
Clinical Informatics Physician
MD2016-0585
NM
Other
Enumeration date
02/02/2015
Last updated
05/19/2020
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