Provider Demographics
NPI:1316146202
Name:BODE, ANNE K (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:K
Last Name:BODE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:K
Other - Last Name:GILBRIDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1216 N CASCADE AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2304
Mailing Address - Country:US
Mailing Address - Phone:719-365-5808
Mailing Address - Fax:
Practice Address - Street 1:1400 E BOULDER ST
Practice Address - Street 2:PATHOLOGY DEPARTMENT
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-365-5808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV208D00000X207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology