Healthcare Provider Details

I. General information

NPI: 1255446894
Provider Name (Legal Business Name): CHARLOTTE MARIE AGNONE MD FACS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 WOLF RIDGE DR
DUBLIN OH
43017-2995
US

IV. Provider business mailing address

3303 WOLF RIDGE DR
DUBLIN OH
43017-2995
US

V. Phone/Fax

Practice location:
  • Phone: 614-499-1863
  • Fax:
Mailing address:
  • Phone: 614-499-1863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number35.062148
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: