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General NPI Number Information
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NPI Number | 1730076415
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Entity Type | Individual
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Provider Name | MELISSA BOGERT OD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1200 E MAIN ST STE 2
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City | SPARTANBURG
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State | SC
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Zip | 29307-1738
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Country | US
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Telephone | 864-585-7807
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Fax | 864-585-8272
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Provider Business Mailing Address
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Address Line | 812 DEERCROSS LN
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City | WAXHAW
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State | NC
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Zip | 28173-6603
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Country | US
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Telephone | 704-763-0803
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2545
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License Number State | SC
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