Individual
DR. MARIA A BOGAERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1514 AMHERST ST, WINCHESTER, VA 22601-2803
(540) 667-4499
(540) 722-4172
Mailing address
1514 AMHERST ST, WINCHESTER, VA 22601-2803
(540) 667-4499
(540) 722-4172
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101051206
VA
207ND0900X
Dermatopathology Physician
0101051206
VA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
0101051206
VA
207NS0135X
Procedural Dermatology Physician
0101051206
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001717410
MTST BCBS
WV
05
—
005900433
—
VA
05
—
0070048000
—
WV
01
—
019313
ANTHEM BCBS
VA
Enumeration date
01/30/2006
Last updated
08/23/2019
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