Individual
DR. MOHD I BODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3490 NE RALPH POWELL RD, SUITE B, LEES SUMMIT, MO 64064-2361
(816) 554-7100
(816) 478-0288
Mailing address
3490 NE RALPH POWELL RD, SUITE B, LEES SUMMIT, MO 64064-2361
(816) 554-7100
(816) 478-0288
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2001025771
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200198790A
—
OK
05
—
200556350B
—
KS
05
—
205760713
—
MO
Enumeration date
06/06/2006
Last updated
02/01/2022
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