Provider Demographics
NPI:1164835724
Name:BOGGS, NATHAN ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ALLEN
Last Name:BOGGS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4954 NORTH PALMER ROAD
Mailing Address - Street 2:BUILDING 19, ROOM 4112
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5630
Mailing Address - Country:US
Mailing Address - Phone:301-295-7988
Mailing Address - Fax:301-319-8299
Practice Address - Street 1:4954 NORTH PALMER ROAD
Practice Address - Street 2:BUILDING 19, ROOM 4112
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5630
Practice Address - Country:US
Practice Address - Phone:301-295-7988
Practice Address - Fax:301-319-8299
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2023-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD045081207R00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine