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Individual

BRADFORD K BOHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5475 S 500 E, OGDEN, UT 84405-6905
(800) 880-3566
(801) 733-5872
Mailing address
2829 E 6200 S, OGDEN, UT 84403
(801) 476-3084

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
85-174080-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107005086102
IHC
UT
01
2000026
UNITED HEALTHCARE
UT
01
219494
ALTIUS
UT
01
52175
HEALTHY U
UT
01
5823
DESERET MUTUAL
UT
01
68295
PEHP
UT
01
870458780B01
EDUCATORS MUTUAL
UT
01
PR00182
MOLINA
UT
Enumeration date
08/11/2006
Last updated
07/08/2007
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