Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BLAKE MICHAEL BODENDORFER, M.D.
Active Sole ProprietorBLAKE MICHAEL BODENDORFER, M.D. is a Adult Reconstructive Orthopaedic Surgery healthcare provider located in COUNCIL BLUFFS, Iowa. NPI 1083000905 is currently active in the NPPES registry. Verify at CMS.
Adult Reconstructive Orthopaedic Surgery · COUNCIL BLUFFS, IA
Registration Details
- NPI Number
- 1083000905
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 7, 2015 (11.309093543605 yrs)
- Last Updated
- Aug 2, 2021
- License
-
036152051 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 EDMUNDSON PL STE 500COUNCIL BLUFFS, IA, 515034619Browse IA providers · Browse ZIP 51503
- Phone
- 7123235333
- Primary Specialty
-
Adult Reconstructive Orthopaedic Surgery
207XX0005X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.