Individual
JONATHAN CARL BOGUSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125069841
IL
207L00000X
Anesthesiology Physician
Primary
39579
SC
208600000X
Surgery Physician
LL39579
SC
Other
Enumeration date
05/31/2016
Last updated
10/13/2020
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