Margie A Agahan, O.D.
Individual provider Active NPI Optometrist · Tamuning, GU
NPI 1902097652 · NPPES record last updated Aug 7, 2007
Key facts
- NPI
- 1902097652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- GUAM LIC. 016 (GU)
- Practice address
- 590 South Marine Drive
Suite 131, Gitc BLDG
Tamuning, GU 96931 - Phone
- (671) 649-0600
- Fax
- (671) 649-0666
- NPI assigned
- Aug 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GUAM LIC. 016 | GU | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | GUAM LIC. 016 | GU | Yes |
Addresses
Primary practice location
590 South Marine Drive
Suite 131, Gitc BLDG
Tamuning, GU 96931
Mailing address
236 Kalamsa Macheche
Dededo, GU 96921
Phone (671) 649-0600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 168 | Medicaid | GU |
Other names
- Dr. Margie Asdilla Agahan
Other providers in Tamuning, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.