Healthcare Provider Details

I. General information

NPI: 1295736064
Provider Name (Legal Business Name): N. AGRAWAL MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1614 E MAIN ST
RICHMOND IN
47374-4323
US

IV. Provider business mailing address

1614 E MAIN ST
RICHMOND IN
47374-4323
US

V. Phone/Fax

Practice location:
  • Phone: 765-962-0823
  • Fax: 765-966-0773
Mailing address:
  • Phone: 765-962-0823
  • Fax: 765-966-0773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIN

VIII. Authorized Official

Name: DR. NARENDRA AGRAWAL
Title or Position: PRESIDENT
Credential: MD
Phone: 765-962-0823