Provider Demographics
NPI:1295714327
Name:ANAGNOS, DAMON PHILIP (MD)
Entity type:Individual
Prefix:DR
First Name:DAMON
Middle Name:PHILIP
Last Name:ANAGNOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5017
Mailing Address - Country:US
Mailing Address - Phone:828-268-0082
Mailing Address - Fax:828-268-0087
Practice Address - Street 1:141 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5017
Practice Address - Country:US
Practice Address - Phone:828-268-0082
Practice Address - Fax:828-268-0087
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96004392082S0105X, 208600000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC510456858OtherHEALTHCARE SAVINGS
NC510456858OtherPHCS
NC8911088Medicaid
NC11088OtherBC/BS OF NC
NC1300361OtherUNITED HEALTHCARE
NCC5607OtherMEDCOST
NC0262412002OtherCIGNA
NC11088OtherSTATE HEALTH PLAN
NC510456858OtherCHAMPUS/TRICARE
NCP00054841OtherRAILROAD MEDICARE
NC510456858OtherPHCS
NC8911088Medicaid