Individual
DANIEL JOHN BODNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1310 BROADWAY, WISCONSIN DELLS, WI 53965-1358
(608) 253-1171
(608) 253-8012
Mailing address
1310 BROADWAY, WISCONSIN DELLS, WI 53965-1358
(608) 253-1171
(608) 253-8012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82436
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083295745
—
WI
Enumeration date
04/15/2021
Last updated
10/07/2024
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