Provider Demographics
NPI:1326068362
Name:BOGGS, CHRIS (MD)
Entity Type:Individual
Prefix:
First Name:CHRIS
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 1:4237 RIVER HILLS DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-6446
Mailing Address - Country:US
Mailing Address - Phone:843-281-2778
Mailing Address - Fax:843-281-2785
Practice Address - Street 1:4237 RIVER HILLS DR STE 150
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-6446
Practice Address - Country:US
Practice Address - Phone:843-281-2778
Practice Address - Fax:843-281-2785
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17630207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT13027Medicaid
SCT13027Medicaid
SC7025Medicare PIN
SCF84939Medicare UPIN