Individual
NICHOLAS A BODMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9576 HIGHWAY 70, MINOCQUA, WI 54548-9067
(715) 358-1275
Mailing address
9576 HIGHWAY 70, MINOCQUA, WI 54548-9067
(715) 358-1275
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
64102
WI
2085R0202X
Diagnostic Radiology Physician
ML 60095646
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/30/2008
Last updated
03/31/2026
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