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Individual

DR. WILLIAM K BOGACHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
823 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 449-1010
(843) 497-6171
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPT, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD13929
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000257216
UNISON HEALTH PLAN
SC
05
139291
SC
01
2148886
CIGNA
SC
01
340002835
RAILROAD MEDICARE
SC
01
5586006
AETNA
SC
05
89064R1
NC
05
GP1418
SC
05
GP4522
SC
01
P00360552
RAILROAD MEDICARE
SC
Enumeration date
11/04/2005
Last updated
06/27/2012
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