Individual
DR. STEPHEN J BOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1170 WYKE RD., SHELBY, NC 28150-3406
(704) 482-6767
(704) 484-2507
Mailing address
1170 WYKE RD, SHELBY, NC 28150-4259
(704) 482-6767
(704) 600-6232
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
16420
SC
207W00000X
Ophthalmology Physician
Primary
36496
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0860143
UNITED HEALTH CARE
—
01
—
104386
WELLNESS PLAN
—
01
—
16428
BCBS
NC
01
—
16428
BCBS
SC
01
—
16428
BLUE CROSS BLUE SHIELD
—
01
—
2109355
MAMSI INSURANCE
—
01
—
561705441
AETNA
—
01
—
561705541
WORKMANS COMP
NC
01
—
561705541
WORKMANS COMP
SC
01
—
561705541
CMS 1500
—
05
—
8916428
—
NC
01
—
D44881
FIRST HEALTH
—
01
—
D448817495
MC SOUTH CAROLINA
—
05
—
N36496
—
SC
01
—
S341421
HEALTHSOURCE SC INC
—
Enumeration date
12/20/2005
Last updated
10/05/2023
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