JOHN BODINE PA NPI 1457530230

NPI Information

  • NPI: 1457530230
  • Provider Name: JOHN BODINE, PA
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 3601 W 13 MILE RD
    ROYAL OAK, MI
    ZIP 48073
  • Phone: (248) 898-4021

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NPI Details

John Bodine, PA is a medical physician assistant in Royal Oak, MI. John Bodine, PA NPI is 1457530230. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3601 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073-712
Phone: (248) 898-4021
Fax: (248) 898-1473

The enumeration date for this NPI number is 10/30/2007 and was last updated on 10/30/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical5601001693MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10N33470MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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