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Individual

MICHELLE E BODIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
2500 W STRUB RD, SUITE 330, SANDUSKY, OH 44870-5390
(419) 626-6700
(419) 626-6710
Mailing address
2500 W STRUB RD, SUITE 330, SANDUSKY, OH 44870-5390
(419) 626-6700
(419) 626-6710

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001548
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000349619
ANTHEM BLUE CROSS
OH
01
P00195046
RR MEDICAR
OH
Enumeration date
07/08/2005
Last updated
01/24/2012
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