Individual
DR. MYRON A BODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
21245 LORAIN RD, SUITE 115, FAIRVIEW PARK, OH 44126-2140
(440) 356-1989
(440) 356-5944
Mailing address
21245 LORAIN RD, STE 115, FAIRVIEW PARK, OH 44126-2140
(440) 356-1989
(440) 356-5944
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
36-00-1747
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360041
—
OH
01
—
4800325161
RAILROAD MEDICARE
OH
Enumeration date
06/28/2005
Last updated
09/17/2012
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