Individual
KATHLEEN PATT BOGACZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
390 S MAIN ST STE 201, ROCKY MOUNT, VA 24151-1767
(540) 484-4800
(540) 484-4847
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5715
(540) 224-5684
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101258121
VA
207R00000X
Internal Medicine Physician
036069602
IL
Other
Enumeration date
07/14/2006
Last updated
08/16/2022
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