Healthcare Provider Details

I. General information

NPI: 1659069821
Provider Name (Legal Business Name): SIMRAN AGRAWAL MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDSTAR UNION HOSPITAL 201 E UNIVERSITY PARKWAY
BALTIMORE MD
21218
US

IV. Provider business mailing address

3700 TOONE ST APT 2339
BALTIMORE MD
21224-5176
US

V. Phone/Fax

Practice location:
  • Phone: 410-554-2284
  • Fax: 410-554-2184
Mailing address:
  • Phone: 737-334-7895
  • Fax: 410-554-2184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0105961
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: