Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KEITH O BODRERO, D.O.
Deactivated Sole ProprietorFamily Medicine · COLORADO SPRINGS, CO
This NPI has been deactivated.
The record was deactivated on March 16, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1386642536
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 12, 2005 (0.67671232876712 yrs)
- Last Updated
- Aug 29, 2013
- Deactivated
- Mar 16, 2006
- License
-
32687 (CO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6080 N CAREFREE CIRCOLORADO SPRINGS, CO, 809222402Browse CO providers · Browse ZIP 80922
- Phone
- 7195509100
- Fax
- 7193800384
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in COLORADO SPRINGS, CO
| Name | Credential | NPI |
|---|---|---|
| DR. GERALD A. HAMSTRA | D.O. | 1124020417 |
| DR. JOHANE LAPORTE | MD | 1922002351 |
| KERN LOW | M.D. | 1396740221 |
| DR. PAOLO JUAN BAHR | DO | 1013912963 |
| DR. SHANE ERIN MCCARTHY | D.O. | 1629073150 |
| RICHARD ANTHONY DIASIO | MD | 1427058965 |
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.