Dr. Stephen Earl Boodin
Neurosurgeon
909 W Maple Rd Suite 104
Clawson
, Michigan 48017-1000
Dr. Stephen Earl Boodin
Neurosurgeon
909 W Maple Rd Suite 104
Clawson
, Michigan 48017-1000
(248) 288-0530
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About
Features
Specialties
- Neurosurgeon
Languages spoken
- English
Location
First Address
- Dr. Stephen Earl Boodin
- 909 W Maple Rd Suite 104
- Clawson, MI
- Zip : 48017-1000
- Fax : (248) 288-0530
- Phone : (248) 288-3200
Second Address
- Dr. Stephen Earl Boodin
- 909 W Maple Rd Suite 104
- Clawson, MI
- Zip : 48017-1000
- Fax : (248) 288-0530
- Phone : (248) 288-3200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207T00000X | Neurosurgeon | 032164 | MI |
National Provider Identifier
| NPI | 1093799702 |
|---|---|
| Provider Name | Dr. Stephen Earl Boodin |
| First Address | Clawson, MI 48017-1000 |
| Second Address | Clawson, MI 48017-1000 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/12/2005 |
| Last Update Date | 31/03/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 2950744 | (05) | MI |
| A76633 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.