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Individual

BRYCEN D. BODELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8701 W WATERTOWN PLANK RD, MILWAUKEE, WI 53226-3548
(414) 955-4575
(414) 955-6409
Mailing address
925 E MCDOWELL RD FL 2, PHOENIX, AZ 85006-2502
(602) 839-3339
(602) 839-3300

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
67931-20
WI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
67931
WI
208600000X
Surgery Physician
R74636
AZ
390200000X
Student in an Organized Health Care Education/Training Program
TL.000865
CO

Other

Enumeration date
06/09/2014
Last updated
10/11/2022
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