Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 35084548 | OH |
Y | 2086X0206X | Surgical Oncologist | 35084548 | OH |
NPI | 1740247816 |
---|---|
Provider Name | Doreen M Agnese |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43212-3117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 30/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2486920 | (05) | OH |
H13442 | (02) |