Bodendorfer, Blake Michael

Bodendorfer, Blake Michael is an sole proprietor health care provider with primary practice located at 1 Edmundson Pl Ste 500 , Council Bluffs IA 51503-4619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Bodendorfer, Blake Michael can be contacted via phone (712) 323-5333.

Contact Information

Primary practice address
1 Edmundson Pl Ste 500 Council Bluffs IA 51503-4619
Phone: (712) 323-5333
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 036152051 Illinois

Profile Details

NPI number 1083000905
LBN Legal business name Bodendorfer, Blake Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 7th, 2015
Last updated Aug 2nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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