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1093791097

NPI Code Detail

MEDICARE: CHRISTOPHER S. VAGNONI M.D.

MEDICARE: CHRISTOPHER S. VAGNONI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35521	SC
2	207R00000X	Internal Medicine Physician	D0059987	MD
3	208000000X	Pediatrics Physician	D0059987	MD
4	208M00000X	Hospitalist Physician	35521	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00135051	OTHER	MD	TRAVELERS MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J697 002	OTHER	DC	BLUE CHOICE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	641385 02	OTHER	MD	CAREFIRST BC BS
6	641385 01	OTHER	MD	CAREFIRST BC BS

General Provider Information

NPI Number	:	1093791097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER S. VAGNONI M.D.

Provider Business Mailing Address
First Line	:	800 N FANT STREET
Second Line	:
City	:	ANDERSON
State	:	SC
Zip	:	29621
Country	:	US
Telephone Number	:	864-314-8549
Fax Number	:	864-512-2020

Provider Business Practice Location Address
First Line	:	800 N FANT ST
Second Line	:
City	:	ANDERSON
State	:	SC
Zip	:	29621-5708
Country	:	US
Telephone Number	:	864-314-8549
Fax Number	:	864-512-2020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	05/20/2019

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Directions to “ CHRISTOPHER S. VAGNONI M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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