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:
Health care specialties
| Specialty | Code | License # | 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 last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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