Dr. Brandon Charles Bodager, M.D.
Radiology, Diagnostic Radiology in Mequon, WI. Individual provider (NPI-1).
NPI number1811263304
StatusActive
Last updated in NPPESFeb 14, 2025
Details
- NPI
- 1811263304
- Entity type
- Individual (NPI-1)
- Name
- Dr. Brandon Charles Bodager
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 28, 2012
- Certification date
- Feb 14, 2025
- Last updated
- Feb 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | 61321 | WI | Yes |
Practice location
10945 N Port Washington Rd Ste 201Mequon, WI 53092-5078
Phone 262-292-3151
Mailing address
10945 N Port Washington Rd Ste 201Mequon, WI 53092-5078
Phone 262-292-3151
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