Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. THOMAS WALTER BODENDORFER, PHARMD
Active Sole ProprietorPharmacist Clinician (PhC) · LATHRUP VILLAGE, MI
Registration Details
- NPI Number
- 1104548999
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 19, 2022 (3.6066843897496 yrs)
- Last Updated
- Sep 19, 2022
- License
-
5302021966 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
28053 SUNSET BLVD WLATHRUP VILLAGE, MI, 480767016Browse MI providers · Browse ZIP 48076
- Phone
- 2482529720
- Primary Specialty
-
Pharmacist Clinician (PhC)
1835P0018X
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.