Dr Mavictoria Agustin, MD is a
Pediatrics physician based in Bishopville, South Carolina. Dr Mavictoria Agustin is licensed to practice in North Carolina (license number 2010-00505) and her current practice location is 545 Sumter Hwy, Bishopville, South Carolina. She can be reached at her office (for appointments etc.) via phone at
(803) 484-5317.
NPI number for Dr Mavictoria Agustin is 1760555494 and her current mailing address is Po Box 1090, Hartsville, South Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1760555494.
Physician's Profile
| Full Name | Dr Mavictoria Agustin |
|---|
| Gender | Female |
|---|
| Speciality | Pediatrics |
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| Location | 545 Sumter Hwy, Bishopville, South Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1760555494
- Provider Enumeration Date: 11/17/2006
- Last Update Date: 10/27/2014
Medical Identifiers
Medical identifiers for Dr Mavictoria Agustin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760555494 | NPI | - | NPPES |
| 410323800 | Medicaid | MD | |
| 8902644 | Medicaid | NC | |
| 355715 | Medicaid | SC | |
| 201000505 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 2010-00505 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mavictoria Agustin is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mavictoria Agustin, MD
Po Box 1090,
Hartsville, SC 29551-1090
Ph: (843) 857-0111 | Dr Mavictoria Agustin, MD
545 Sumter Hwy,
Bishopville, SC 29010-7601
Ph: (803) 484-5317 |
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