Healthcare Provider Details

I. General information

NPI: 1104926021
Provider Name (Legal Business Name): RAMESH K AGARWAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 05/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E CARROLL ST UNIT 103
SALISBURY MD
21801
US

IV. Provider business mailing address

145 E CARROLL ST UNIT 103
SALISBURY MD
21801-5454
US

V. Phone/Fax

Practice location:
  • Phone: 410-749-4999
  • Fax: 410-749-9300
Mailing address:
  • Phone: 410-749-4999
  • Fax: 410-749-9300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberDO054807
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberD0054807
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: