Individual
GEOFFREY R BODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6608 KENNEY PL, EDINA, MN 55439-1427
(952) 947-9445
Mailing address
6608 KENNEY PL, EDINA, MN 55439-1427
(952) 947-9445
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
29842
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0533448
—
IA
01
—
1006999
PREFERRED ONE
MN
01
—
108789
UCARE
MN
01
—
22825
AMERICA'S PPO
MN
01
—
232903
MIDLANDS CHOICE INC
MN
01
—
300046433
RAILROAD MEDICARE WI
WI
05
—
32385300
—
WI
01
—
47Q34BO
BLUE CROSS
MN
01
—
4T045BO
BLUE CROSS
MN
05
—
794265600
—
MN
01
—
9253416
DAKOTA CARE
MN
01
—
HP12925
HEALTHPARTNERS
MN
01
—
P00126385
RAILROAD MEDCIARE MN
MN
Enumeration date
05/16/2006
Last updated
07/19/2023
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