DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. EDWARD JAMES BODMER, DPM

Active Sole Proprietor

Podiatrist · GOLD CANYON, AZ

Registration Details

NPI Number
1801882006
Provider Type
Individual
Gender
Male
NPI Issued
Sep 22, 2005 (20.613774385322 yrs)
Last Updated
Apr 19, 2018
License
0152 (AZ)
Sole Proprietor
Yes

Practice Information

Address
9765 E DEAD SURE PL
GOLD CANYON, AZ, 852187176
Browse AZ providers · Browse ZIP 85218
Phone
4803633066
Fax
4809838153
Primary Specialty
Podiatrist
213E00000X
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.