Provider Demographics
NPI:1164531356
Name:BOGGS, MARCELLUS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCELLUS
Middle Name:
Last Name:BOGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM ONE 2ND FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-432-7424
Mailing Address - Fax:
Practice Address - Street 1:2 HOT METAL ST
Practice Address - Street 2:QUANTUM ONE 2ND FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2348
Practice Address - Country:US
Practice Address - Phone:412-432-7424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038717L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC32947Medicare UPIN
PA181245Medicare ID - Type Unspecified