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General NPI Number Information
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NPI Number | 1609371459
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Entity Type | Individual
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Provider Name | MOHIT SHIV AGARWAL MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 615 FAIRHURST ST
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City | STERLING
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State | CO
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Zip | 80751-4523
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Country | US
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Telephone | 970-399-5607
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Fax |
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Provider Business Mailing Address
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Address Line | 1207 COURT ST
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City | PUEBLO
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State | CO
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Zip | 81003-2820
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Country | US
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Telephone | 615-294-3890
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | DR.0071488
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License Number State | CO
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