Individual
VIJAYA PRAKASH BOGGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.,D
Contact information
Practice address
2511 OLD CORNWALLIS RD, SUITE 200, DURHAM, NC 27713-1869
(919) 932-5700
(919) 933-6881
Mailing address
2511 OLD CORNWALLIS RD, SUITE 200, DURHAM, NC 27713-1869
(919) 932-5700
(919) 933-6881
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2015-02298
NC
208D00000X
General Practice Physician
2015-02298
NC
Other
Enumeration date
06/09/2009
Last updated
04/19/2016
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