Healthcare Provider Details

I. General information

NPI: 1609098367
Provider Name (Legal Business Name): AGARWAL NEPHROLOGY AND HYPERTENSION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 13TH STREET
COLUMBUS GA
31901
US

IV. Provider business mailing address

1110 13TH STREET
COLUMBUS GA
31901
US

V. Phone/Fax

Practice location:
  • Phone: 706-494-8900
  • Fax: 706-494-8901
Mailing address:
  • Phone: 706-494-8900
  • Fax: 706-494-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DEEPALI S AGARWAL
Title or Position: SECRETARY
Credential: M.D.
Phone: 706-494-8900