Individual
DAWN A AGOSTINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1545 POTOMAC AVE, HAGERSTOWN, MD 21742-2930
(301) 797-3030
Mailing address
1545 POTOMAC AVE, HAGERSTOWN, MD 21742-2930
(301) 797-3030
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1772
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111658400
—
MD
01
—
61971602/LX71LO
CAREFIRST
MD
01
—
P00126922
RAILROAD MEDICARE
MD
01
—
S818-004
CAREFIRST PPO
MD
Enumeration date
08/18/2005
Last updated
02/09/2023
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