Individual
MR. DAVID BRAD BOGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904
(920) 456-6000
(920) 456-5590
Mailing address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 456-6000
(920) 456-5590
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2465
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1018214003
DIAMOND PROVIDER #
WI
05
—
43399200
—
WI
01
—
51135
WISCONSIN LICENSE
WI
Enumeration date
06/03/2006
Last updated
11/12/2025
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