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General NPI Number Information
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NPI Number | 1750349627
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Entity Type | Individual
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Provider Name | CARMEN V BOGDAN MD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 2191 SOUTH BLVD SUITE 101C
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City | AUBURN HILLS
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State | MI
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Zip | 48326-3479
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Country | US
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Telephone | 248-724-1420
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Fax | 248-724-1425
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Provider Business Mailing Address
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Address Line | 3620 JOSHUA DR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-5267
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Country | US
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Telephone | 248-724-1420
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Fax | 248-724-1420
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301064314
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License Number State | MI
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