MEDICARE: BOGDAN IRIMIES DO

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
1	207P00000X	Emergency Medicine Physician	34008574	OH
2	207P00000X	Emergency Medicine Physician	1059	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1851378806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOGDAN IRIMIES DO

Provider Business Mailing Address
First Line	:	5700 DARROW RD
Second Line	:	SUITE 106
City	:	HUDSON
State	:	OH
Zip	:	44236-5021
Country	:	US
Telephone Number	:	330-656-5911
Fax Number	:	330-656-5901

Provider Business Practice Location Address
First Line	:	1296 TOD PL NW
Second Line	:	SUITE 200
City	:	WARREN
State	:	OH
Zip	:	44485-2474
Country	:	US
Telephone Number	:	330-841-4000
Fax Number	:	330-656-5901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	02/01/2024

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Directions to “ BOGDAN IRIMIES DO” Practice Location

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