Individual
VAN B BOGGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6444 MONROE ST, SUITE 3, SYLVANIA, OH 43560-1454
(419) 885-2553
(419) 885-7070
Mailing address
6444 MONROE ST, SUITE 3, SYLVANIA, OH 43560-1454
(419) 885-2553
(419) 885-7070
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35-047650 B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0492391
—
OH
Enumeration date
08/21/2006
Last updated
05/31/2011
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