Individual
BRYCEN D. BODELL
Active
Individual
BRYCEN D. BODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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