Individual
GLENN BOGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, SAINT LOUIS, MO 63110-1003
(314) 454-8134
Mailing address
47 PORTLAND DR, FRONTENAC, MO 63131-3300
(314) 997-6173
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2001006321
MO
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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