Healthcare Provider Details

I. General information

NPI: 1134682032
Provider Name (Legal Business Name): SHREE AGRAWAL-PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHREE AGRAWAL MD

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N SENATE BLVD STE 220
INDIANAPOLIS IN
46202-1260
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-962-3700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number57.247117
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number01099654A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: