Individual
KEVIN BOGENSCHUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
7911 MICHIGAN RD, INDIANAPOLIS, IN 46268-1915
(317) 956-6288
Mailing address
2035 BROADWAY ST, INDIANAPOLIS, IN 46202-1760
(513) 504-9396
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IN
Other
Enumeration date
06/22/2017
Last updated
06/22/2017
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