Individual
DR. ANTHONY DEAN AGRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
290 E TOWN ST, COLUMBUS, OH 43215-4602
(614) 788-5400
(614) 788-5500
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
(614) 788-5400
(614) 788-5500
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
35073306
OH
390200000X
Student in an Organized Health Care Education/Training Program
35-073306
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2072206
—
OH
Enumeration date
07/15/2005
Last updated
08/05/2021
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