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Individual

DR. DONALD R BODNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-5661
(216) 286-6341
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35-044291
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000025982
ANTHEM
OH
01
000000216802
UNISON
OH
01
000000507513
ANTHEM
OH
05
0441963
OH
01
0639506
AETNA
OH
01
1900369
UHC
OH
01
363367
WELLCARE
OH
01
639506
AETNA
OH
01
741846
BUCKEYE
OH
01
P00364270
RAILROAD MEDICARE
OH
Enumeration date
07/10/2006
Last updated
12/07/2020
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