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Individual

CHADWICK BOGGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
177884
AK
207R00000X
Internal Medicine Physician
77081
MN
208M00000X
Hospitalist Physician
Primary
77081
MN

Other

Enumeration date
01/02/2020
Last updated
08/06/2024
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