Organization Active NPI

Carmen V Bogdan MD PLLC

  • Internal Medicine Physician
  • Auburn Hills, MI
National Provider Identifier
1669457602
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301064314 Issued in MI
Legal business name
CARMEN V BOGDAN MD PLLC
Practice address
2191 South Blvd
Auburn Hills, MI 48326-3479
Phone
(248) 724-1420
NPI assigned
Dec 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carmen V Bogdan, MD
Title
Managing Agent
Phone
(248) 203-0917

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301064314 MI Primary

Addresses

Primary practice location

2191 South Blvd
Auburn Hills, MI 48326-3479

Mailing address

3620 Joshua Dr
Rochester Hills, MI 48307-5267
Phone (248) 203-0917

Other identifiers 1

IdentifierTypeStateIssuer
4726362MedicaidMI

National Provider Directory

National Provider Directory

Locations

36880 Woodward Ave
Ste 101
Bloomfield Hills, MI 48304
Phone (248) 203-1920

44555 Woodward Ave
Ste 502
Pontiac, MI 48341
Phone (248) 858-3938

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1669457602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 JOSHUA DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075267",
            "telephone_number": "248-203-0917",
            "fax_number": "248-203-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 SOUTH BLVD",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483263479",
            "telephone_number": "248-724-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMEN V BOGDAN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "BOGDAN",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "MANAGING AGENT",
        "authorized_official_telephone_number": "248-203-0917",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301064314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4726362",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.