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NPI Code Detail

MEDICARE: CAROL ANN BOGDAN MD

MEDICARE: CAROL ANN BOGDAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology Physician27515SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033102538
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROL ANN BOGDAN MD
Provider Business Mailing Address
First Line : PO BOX 1209
Second Line :
City : MURRELLS INLET
State : SC
Zip : 29576-1209
Country : US
Telephone Number : 843-652-8220
Fax Number : 843-527-7080
Provider Business Practice Location Address
First Line : 2405 N FRASER ST
Second Line :
City : GEORGETOWN
State : SC
Zip : 29440-7764
Country : US
Telephone Number : 843-545-7274
Fax Number : 843-545-8315
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 03/23/2021

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