Bogomilov, Boris V

Bogomilov, Boris V is an individual health care provider with primary practice located at 3211 N Northhills Blvd Suite 110, Fayetteville AR 72703-4007. He recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, which is considered as his primary health care specialty. Bogomilov, Boris V can be contacted via phone (479) 571-4338.

Contact Information

Primary practice address
3211 N Northhills Blvd Suite 110 Fayetteville AR 72703-4007
Phone: (479) 571-4338
Fax: (479) 571-4015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X E4311 Arkansas

Profile Details

NPI number 1790749638
LBN Legal business name Bogomilov, Boris V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790749638 NPPES
Arkansas Other E4311 STATE LICENSE
Arkansas MEDICAID 156638001 STATE LICENSE
Arkansas Other 5020011800 STATE LICENSE
Arkansas MEDICAID 200005240A STATE LICENSE
Arkansas Other 7934401 STATE LICENSE
Arkansas MEDICAID 207453101 STATE LICENSE

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