Provider Demographics
NPI:1598451114
Name:BOGGS, GARRETT HANS JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:HANS JONATHAN
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 1:1026 7TH ST W
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3828
Mailing Address - Country:US
Mailing Address - Phone:651-758-9500
Mailing Address - Fax:651-359-2754
Practice Address - Street 1:1026 7TH ST W
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3828
Practice Address - Country:US
Practice Address - Phone:651-758-9500
Practice Address - Fax:651-359-2754
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program