Individual
MYRON O BODNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3003 W GOOD HOPE ROAD, MILWAUKEE, WI 53209
(414) 352-3100
(414) 247-4597
Mailing address
3003 W GOOD HOPE ROAD, MILWAUKEE, WI 53209
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29853
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32367100
—
WI
01
—
P00449418
RR MEDICARE
WI
Enumeration date
07/05/2006
Last updated
11/23/2021
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