Individual
ANDREW MILLER IBRAHIM BOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13700 ST FRANCIS BLVD, SUITE 103, MIDLOTHIAN, VA 23114-3222
(804) 379-2414
(804) 379-2413
Mailing address
1115 BOULDERS PKWY, SUITE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101254284
VA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
0101254284
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2007
Last updated
05/18/2020
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