Individual
DR. THOMAS C MOGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 ROANOKE ST, CHRISTIANSBURG, VA 24073-3025
(540) 381-6000
Mailing address
37 RIDGEFIELD LN, RADFORD, VA 24141-3607
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101-043065
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010029155
—
VA
05
—
5600995
—
VA
Enumeration date
11/18/2005
Last updated
12/09/2020
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