DR. AIDA BODOUR (NPI# 1669430708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669430708 |
| Entity Type | Individual |
| Full Name | DR. AIDA BODOUR |
| Credential | M.D. |
| Practice Address |
1400 E Michigan Ave Jackson MI 49202-3518 |
| Practice Telephone | 5177874727 |
| Practice Fax Number | 5177841747 |
| Mailing Telephone | 5177874727 |
| Mailing Fax Number | 5177841747 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
4301032967 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
1400 E MICHIGAN AVE |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-3518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235454059 | Mitchell Myers, M.d. | Psychiatry & Neurology | 2906 North State Street, Suite 301, Jackson, MS 39216 | 2010-04-05 |
| 1477745842 | Catherine Haynes Wuthrich | Psychiatry & Neurology | 2092 Lilac Lane, Jackson, WY 83002 | 2007-08-09 |
| 1003907460 | Patrick E Weldon | Psychiatry & Neurology | 1860 Chadwick Drive, Suite 258, Jackson, MS 39204 | 2006-09-28 |
| 1801991401 | James H Spruill Jr. | Psychiatry & Neurology | 614 Skyline Dr, Jackson, TN 38301-3923 | 2006-09-14 |
| 1174628903 | Michael W Brueggeman | Psychiatry & Neurology | 700 West Forest, Ste 200, Jackson, TN 38301 | 2006-09-14 |
| 1417962952 | Mohamad R Karami-sichani | Psychiatry & Neurology | 50 Bent Creek Ln, Jackson, TN 38305-2170 | 2006-07-31 |
| 1760427496 | Sumathira T Sathanandan | Psychiatry & Neurology | 700 West Forest, Ste. 200, Jackson, TN 38301 | 2006-06-17 |
| 1174574701 | Kathleen A. Messenger | Psychiatry & Neurology | 971 Lakeland Dr Ste 557, Jackson, MS 39216-4661 | 2006-05-16 |
| 1891751806 | Umesh Verma | Psychiatry & Neurology | 1418 E Michigan Ave, Jackson, MI 49202-3518 | 2006-04-26 |
| 1093791220 | Jimmy V Wolfe | Psychiatry & Neurology | 1200 N State St Ste 420, Jackson, MS 39202-2027 | 2005-12-20 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.