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General NPI Number Information
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NPI Number | 1609018944
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Entity Type | Individual
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Provider Name | MICHAEL JAMES DODEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 4420 LAKE BOONE TRL
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City | RALEIGH
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State | NC
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Zip | 27607-7505
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Country | US
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Telephone | 415-529-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 7288 MARMOTA ST
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City | VENTURA
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State | CA
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Zip | 93003-6845
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Country | US
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Telephone | 415-529-8800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A118151
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2021-00666
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License Number State | NC
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