Individual
DR. NICHOLAS BARRETT BODENHEIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
584 HOSPITAL DRIVE, SUITE B, BOLIVIA, NC 28422-9047
(910) 721-4050
(910) 721-4051
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(910) 721-4050
(910) 721-4051
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
201500279
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
NC
Other
Enumeration date
04/28/2011
Last updated
10/25/2020
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