Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080A0000X | Adolescent Medicine | 046893 | GA |
Y | 2080A0000X | Adolescent Medicine | 2012-02327 | NC |
NPI | 1245221613 |
---|---|
Provider Name | Dr. Michael Monroe Ogden |
First Address | High Point, NC 27262-7008 |
Second Address | High Point, NC 27265-8357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 31/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000817176D | (05) | GA |