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NPI Code Detail

MEDICARE: KATERINA M. MICHAELS-BOGDAN M.D.

MEDICARE: KATERINA M. MICHAELS-BOGDAN M.D.
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
1207V00000XObstetrics & Gynecology Physician042485CT

Other Identifiers

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

General Provider Information

NPI Number : 1164484762
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATERINA M. MICHAELS-BOGDAN M.D.
Provider Business Mailing Address
First Line : 2600 TAMARACK AVE STE 200
Second Line :
City : SOUTH WINDSOR
State : CT
Zip : 06074-5560
Country : US
Telephone Number : 860-646-1157
Fax Number : 860-646-9877
Provider Business Practice Location Address
First Line : 2600 TAMARACK AVE STE 200
Second Line :
City : SOUTH WINDSOR
State : CT
Zip : 06074-5560
Country : US
Telephone Number : 860-646-1157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 03/16/2023

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