# DR. MAVICTORIA AGUSTIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1760555494
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 2010-00505 | NC | Yes |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 10/27/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201000505 | — | NC |
| 05 | — | 355715 | — | SC |
| 05 | — | 410323800 | — | MD |
| 05 | — | 8902644 | — | NC |