Individual
JANE G. BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-4101
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2007-00521
NC
2084N0600X
Clinical Neurophysiology Physician
Primary
2007-00521
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909292
—
NC
Enumeration date
01/24/2006
Last updated
02/03/2015
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