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Individual

JOHN BODENSTEINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
105489
MN
2084N0400X
Neurology Physician
Primary
22772
MN
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
29447
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
577421
AZ
Enumeration date
08/18/2006
Last updated
09/13/2011
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