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NPI Code Detail

MEDICARE: DR. THOMAS LEO BODENSTEINER M.D.

MEDICARE:  DR. THOMAS LEO BODENSTEINER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician11737NE

General Provider Information

NPI Number : 1881737864
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS LEO BODENSTEINER M.D.
Provider Business Mailing Address
First Line : 7542 UPTON GREY LN
Second Line :
City : LINCOLN
State : NE
Zip : 68516-5694
Country : US
Telephone Number : 402-328-8135
Fax Number :
Provider Business Practice Location Address
First Line : 4021 S 700 E
Second Line : SUITE 300
City : SALT LAKE CITY
State : UT
Zip : 84107-2192
Country : US
Telephone Number : 800-328-3067
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 07/08/2007

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Directions to “ DR. THOMAS LEO BODENSTEINER M.D.” Practice Location

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