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Individual

MICHAEL TODD BOGGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-3276
(937) 723-3277
Mailing address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-3276
(937) 723-3277

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35-06-7136
OH
208M00000X
Hospitalist Physician
Primary
35.067136
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0169384
OH
Enumeration date
07/19/2005
Last updated
05/05/2023
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