Provider Demographics
NPI:1427010354
Name:BODENHEIMER, WILLIAM FRANKLIN III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANKLIN
Last Name:BODENHEIMER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SAINT PAUL STREET
Mailing Address - Street 2:
Mailing Address - City:BOONSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21713
Mailing Address - Country:US
Mailing Address - Phone:301-432-0623
Mailing Address - Fax:301-432-0765
Practice Address - Street 1:9 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-1334
Practice Address - Country:US
Practice Address - Phone:301-432-0623
Practice Address - Fax:301-432-0624
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056826207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD864001700Medicaid
G90193Medicare UPIN
MD864001700Medicaid