Marc E Boddicker (NPI# 1235103060, PAC ID# 9537155031) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1235103060 |
| PAC ID by PECOS | 9537155031 |
| Professional Enrollment ID | I20100217000747 |
| Full Name | Marc E Boddicker |
| Organization Legal Name | ADVANCED DERMATOLOGY CENTER, PC |
| Address |
710 Saint Anne St Rapid City SD 57701-4670 |
| Phone Number | 6053438000 |
| Gender | M |
| Medical School | UNIVERSITY OF IOWA COLLEGE OF MEDICINE |
| Graduation Year | 1980 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 5294721775 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 710 Saint Anne St, Rapid City, SD 57701-4670 | 6053438000 | ADVANCED DERMATOLOGY CENTER, PC |
| Organization Legal Name | ADVANCED DERMATOLOGY CENTER, PC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ronald S Jurzyk | Dermatology | Advanced Dermatology Center, PC | 464 Wolcott Rd, Wolcott, CT 06716-2626 |
| Jonathan D Medeck | Physician Assistant | Advanced Dermatology Center, PC | 710 Saint Anne St, Rapid City, SD 57701-4670 |
| Deanna Jc Zimkus | Physician Assistant | Advanced Dermatology Center, PC | 464 Wolcott Rd, Wolcott, CT 06716-2626 |
| David Suhocki | Physician Assistant | Advanced Dermatology Center, PC | 464 Wolcott Rd, Wolcott, CT 06716-2626 |
| Street Address |
710 SAINT ANNE ST |
| City | RAPID CITY |
| State | SD |
| Zip | 57701-4670 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan D Medeck | Physician Assistant | Advanced Dermatology Center, PC | 710 Saint Anne St, Rapid City, SD 57701-4670 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Roberta A Kramlich | Psychologist, Clinical | R. P. Renka, M.d.,p.c. | 528 Qunicy St, Rapid City, SD 57701 |
| Ericka L Privitt | Nurse Practitioner | Black Hills Dermatology PC | 7236 Jordan Dr, Suite 101, Rapid City, SD 57701 |
| Julie A Krein | Nurse Practitioner | Black Hills Dermatology PC | 7236 Jordan Dr, Suite 101, Rapid City, SD 57701 |
| Vassilia D Young | Dermatology | Black Hills Dermatology PC | 7236 Jordan Dr, Suite 101, Rapid City, SD 57701 |
| Richard P Renka | Psychiatry | R. P. Renka, M.d.,p.c. | 528 Qunicy St, Rapid City, SD 57701 |
| Danielle L Shafer | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Christine M Zambon | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Kenneth B Peterson | Family Medicine | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Cheryl L Reagan | Nurse Practitioner | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| David K Custis | Physician Assistant | Black Hills Surgical Hospital, LLP | 1730 Haines Ave, Rapid City, SD 57701-0615 |
| Find all physicians in zip 57701 | |||
| City | RAPID CITY |
| Zip Code | 57701 |
| Specialty | DERMATOLOGY |
| City + Specialty | RAPID CITY + DERMATOLOGY |
Please comment or provide details below to improve the information on Marc E Boddicker.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.