Organization
ANDREA M. BODINE, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA M. BODINE M.D. (PRESIDENT)
(413) 442-2226
Entity
Organization
Contact information
Practice address
740 WILLIAMS ST, PITTSFIELD, MA 01201-7463
(413) 442-2226
(413) 442-1314
Mailing address
740 WILLIAMS ST, PITTSFIELD, MA 01201-7463
(413) 442-2226
(413) 442-1314
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
75787
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9706437
—
MA
01
—
M17692
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/08/2007
Last updated
07/11/2007
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