Healthcare Provider Details

I. General information

NPI: 1427247238
Provider Name (Legal Business Name): ALEXANDER BOGDASCHEWSKYI, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 LOCUST LN SUITE 201
WESTMINSTER MD
21157-5075
US

IV. Provider business mailing address

2 LOCUST LN SUITE 201
WESTMINSTER MD
21157-5075
US

V. Phone/Fax

Practice location:
  • Phone: 410-848-8256
  • Fax: 410-848-5950
Mailing address:
  • Phone: 410-848-8256
  • Fax: 410-848-5950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberD37949
License Number StateMD

VIII. Authorized Official

Name: DR. ALEXANDER BOGDASCHEWSKYI
Title or Position: OWNER
Credential: M.D.
Phone: 410-848-8256