Individual
MR. MARC G BODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12731 NEW BRITTANY BLVD, FORT MYERS, FL 33907-3632
(239) 418-0999
(239) 418-0091
Mailing address
PO BOX 61199, FORT MYERS, FL 33906-1199
(239) 418-0999
(239) 418-0091
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
046489
CT
207W00000X
Ophthalmology Physician
Primary
MD.201176
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00601031
—
MS
05
—
1508098
—
LA
Enumeration date
07/13/2007
Last updated
06/07/2010
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