Bodin, Michael Shane

Bodin, Michael Shane is an individual health care provider with primary practice located at 2647 S Saint Elizabeth Blvd Ste 219 , Gonzales LA 70737-5020. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bodin, Michael Shane can be contacted via phone (225) 765-5500.

Contact Information

Primary practice address
2647 S Saint Elizabeth Blvd Ste 219 Gonzales LA 70737-5020
Phone: (225) 765-5500
Fax: (225) 743-2620
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 200969 Louisiana

Profile Details

NPI number 1376743427
LBN Legal business name Bodin, Michael Shane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2007
Last updated Jan 14th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1376743427 NPPES
Louisiana MEDICAID 1238341

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