Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 0101235659 | VA |
NPI | 1053386193 |
---|---|
Provider Name | Dr. Bogdan I Neughebauer |
First Address | Norfolk, VA 23502-3920 |
Second Address | Norfolk, VA 23502-3920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010029511 | (05) | VA |
H99601 | (02) |