Individual
WILLIAM BOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
403 BAYVIEW CT, GLEN CARBON, IL 62034-2981
(808) 224-9526
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2018006733
MO
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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