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Individual

CHRISTOPHER S. VAGNONI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 314-8549
(864) 512-2020
Mailing address
800 N FANT STREET, ANDERSON, SC 29621
(864) 314-8549
(864) 512-2020

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35521
SC
207R00000X
Internal Medicine Physician
D0059987
MD
208000000X
Pediatrics Physician
D0059987
MD
208M00000X
Hospitalist Physician
Primary
35521
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1812767000
WV
05
404927600 01
MD
01
641385 02
CAREFIRST BC BS
MD
01
641385 01
CAREFIRST BC BS
MD
01
J697 002
BLUE CHOICE
DC
01
P00135051
TRAVELERS MEDICARE
MD
Enumeration date
12/21/2005
Last updated
05/20/2019
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