Individual
DR. SHAWN F BODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5568 CLARK AVENUE, SUITE 1, CROMWELL, MN 55726-0116
(218) 644-3811
(218) 644-3813
Mailing address
PO BOX 116, CROMWELL, MN 55726-0116
(218) 644-3811
(218) 644-3813
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40644
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128716800
—
MN
Enumeration date
05/24/2005
Last updated
01/13/2023
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