Individual
KRISTINA BOGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
413 VARDRY ST STE 2A, GREENVILLE, SC 29601-3331
(864) 252-0460
Mailing address
413 VARDRY ST STE 2A, GREENVILLE, SC 29601-3331
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
SC3592
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/05/2020
Last updated
11/16/2022
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