NPIMap

Organization Active NPI

Stephen Boodin MD PC

  • Neurological Surgery Physician
  • Clawson, MI
National Provider Identifier
1174798953
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
STEPHEN BOODIN MD PC
Practice address
909 W Maple Rd
Suite 104
Clawson, MI 48017-1000
Phone
(248) 288-3200
NPI assigned
Apr 23, 2008
Last updated
Apr 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Stephen E. BoodinNPI 1093799702
Title
President
Phone
(248) 288-3200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

909 W Maple Rd
Suite 104
Clawson, MI 48017-1000

Mailing address

909 W Maple Rd
Suite 104
Clawson, MI 48017-1000
Phone (248) 288-3200

National Provider Directory

National Provider Directory

Locations

909 W Maple Rd
Ste 104
Clawson, MI 48017
Phone (248) 288-3200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1174798953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 W MAPLE RD",
            "address_2": "SUITE 104",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480171000",
            "telephone_number": "248-288-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W MAPLE RD",
            "address_2": "SUITE 104",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480171000",
            "telephone_number": "248-288-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN BOODIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "BOODIN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-288-3200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clawson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.