Healthcare Provider Details

I. General information

NPI: 1972571057
Provider Name (Legal Business Name): AGATHA SOPHIA BEYNEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 STRINGTOWN RD
GROVE CITY OH
43123
US

IV. Provider business mailing address

6870 PERIMETER DR SUITE B
DUBLIN OH
43016-8047
US

V. Phone/Fax

Practice location:
  • Phone: 614-871-2273
  • Fax: 877-376-2292
Mailing address:
  • Phone: 614-777-9804
  • Fax: 614-777-9806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-07-5015
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35075015
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: