Provider Demographics
NPI:1184971996
Name:KAJMOLLI, AGON (MD)
Entity type:Individual
Prefix:DR
First Name:AGON
Middle Name:
Last Name:KAJMOLLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1448 10TH AVENUE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3579
Mailing Address - Country:US
Mailing Address - Phone:043-691-6381
Mailing Address - Fax:304-691-8591
Practice Address - Street 1:1600 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 2500
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3656
Practice Address - Country:US
Practice Address - Phone:304-691-1200
Practice Address - Fax:304-691-1287
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2024-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301101488208600000X
WV34333208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery