Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101239639 | VA |
Y | 2080P0208X | Pediatric Infectious Diseases | 0101239639 | VA |
NPI | 1548204340 |
---|---|
Provider Name | Sarah R. Boggs |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Orange, VA 22960-2243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 30/07/2021 |