Individual
MR. JAMES R BOGNANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9998 CROSSPOINT BLVD STE 200, INDIANAPOLIS, IN 46256-3307
(317) 806-8260
(317) 806-8296
Mailing address
9998 CROSSPOINT BLVD STE 200, INDIANAPOLIS, IN 46256-3307
(317) 806-8260
(317) 806-8296
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1035155A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091495
ANTHEM
IN
05
—
100320950
—
IN
Enumeration date
06/13/2006
Last updated
03/30/2021
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