Individual
CHARLES R BOGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2860 CHANNING WAY, SUITE 116, IDAHO FALLS, ID 83404-7531
(208) 535-4567
Mailing address
1452 THREE FOUNTAINS DR, IDAHO FALLS, ID 83404-5641
(208) 535-4567
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M2659
ID
Other
Enumeration date
09/25/2006
Last updated
07/30/2007
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