Provider Demographics
NPI:1487791232
Name:BODNAR, CATHERINE (MD, MPH)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BODNAR
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E RICHMOND DR
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:MI
Mailing Address - Zip Code:48628-9790
Mailing Address - Country:US
Mailing Address - Phone:989-638-7857
Mailing Address - Fax:989-636-4994
Practice Address - Street 1:DOW HEALTH SERVICES 715 EAST MAIN STREET SUITE 102
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48674
Practice Address - Country:US
Practice Address - Phone:989-638-7857
Practice Address - Fax:989-636-4994
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010913442083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE71922Medicare UPIN