Individual
DR. MICHAEL JAMES BODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
21245 LORAIN RD, SUITE 115, FAIRVIEW PARK, OH 44126-2146
(440) 356-1989
(440) 356-5944
Mailing address
21245 LORAIN RD, SUITE 115, FAIRVIEW PARK, OH 44126-2146
(440) 356-1989
(440) 356-5944
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
36003254
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210952
BLUE CROSS AND BLUE SHIELD
OH
05
—
2250184
—
OH
01
—
341944827
AETNA
OH
01
—
480033770
RAILROAD MEDICARE
OH
Enumeration date
01/30/2006
Last updated
06/17/2020
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