Individual
MS. BONNIE J OGDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
30795 23 MILE RD STE 201, CHESTERFIELD, MI 48047-5721
(586) 421-1600
(586) 421-1800
Mailing address
133 S MAIN ST, MOUNT CLEMENS, MI 48043-2308
(586) 329-1880
(586) 231-0055
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601003396
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144254046
—
MI
Enumeration date
07/10/2006
Last updated
12/22/2020
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