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NPI Code Detail

MEDICARE: MS. MEGAN E BOGART PSYCH-MH NP -C

MEDICARE:  MS. MEGAN E BOGART  PSYCH-MH NP -C
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
1207Q00000XFamily Medicine Physician005001131NC
2363LF0000XFamily Nurse Practitioner005001131NC
3363LP0808XPsychiatric/Mental Health Nurse Practitioner0050-01131NC

General Provider Information

NPI Number : 1568496883
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MEGAN E BOGART PSYCH-MH NP -C
Provider Business Mailing Address
First Line : 4300 SAPPHIRE CT 110
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-9079
Country : US
Telephone Number : 252-830-7561
Fax Number : 252-413-0932
Provider Business Practice Location Address
First Line : 130 EDINBURGH SOUTH DR
Second Line : SUITE 208
City : CARY
State : NC
Zip : 27511-7902
Country : US
Telephone Number : 919-467-4745
Fax Number : 919-467-5299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 07/10/2015

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