Individual
DR. TERRENCE DALE BOGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
23470
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16425
BCBS
—
05
—
3810001310
—
WV
01
—
400
PARTNERS
—
01
—
5060613
AETNA
—
05
—
5702569
—
VA
01
—
63947
MEDCOST
—
05
—
8916425
—
NC
Enumeration date
12/12/2005
Last updated
06/28/2010
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