Individual
NAAMA R BOGOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, B1FLOOR UNIVERSITY HOSP RECP C, ANN ARBOR, MI 48109-5030
(734) 936-4566
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301077581
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4321426
—
MI
Enumeration date
08/01/2006
Last updated
02/27/2012
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