Individual
JOHN BODINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-4021
(248) 898-1473
Mailing address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-4021
(248) 898-1473
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001693
MI
Other
Enumeration date
10/30/2007
Last updated
10/30/2007
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