| Organization Name: | DR BODMAN PODIATRY ASSOCIATES INC |
| NPI Number: | 1215008735 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MYRON A BODMAN (PRESIDENT) |
| Mailing Address: | 21245 Lorain Road Suite 115 Fairview Park |
| State: | OH US |
| Postal Code: | 441262140 |
| Phone Number: | 4403561989 |
| Fax Number: | 4403565944 |
| NPI Enumeration Date: | 11/13/2006 |
| NPI Last Update Date: | 08/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 36001747 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |