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Provider Information for 1487958146

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

OLAF BODAMER MD

Gender: MALE

Individual NPI: 1487958146

Calendar   Last Updated:  2018-03-17
  Certification Date: 

Details

Name Value
NPI 1487958146
Enumeration Date 2011-01-10
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: | Fax:
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Primary Practice Address 1475 NW 12TH AVE
MIAMI, FL 33136-1002
United States

Phone: 305-243-6583 | Fax:
View Map External Link
Secondary Practice Address 300 LONGWOOD AVE
BOSTON, MA 02115-5724
United States

Phone: 617-355-6000 | Fax:
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Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 193400000X SINGLE SPECIALTY GROUP
207SG0201X - Medical Genetics Clinical Genetics (M.D.)
MA 261496