MEDICARE: DR. BRAJESH NARAYAN AGARWAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	C1-0003405	DE

General Provider Information

NPI Number	:	1053375337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRAJESH NARAYAN AGARWAL M.D.

Provider Business Mailing Address
First Line	:	503 VAN LEARS RUN
Second Line	:
City	:	VILLANOVA
State	:	PA
Zip	:	19085-1023
Country	:	US
Telephone Number	:	302-633-5302
Fax Number	:	302-633-5582

Provider Business Practice Location Address
First Line	:	1601 KIRKWOOD HWY
Second Line	:	MEDICAL SERVICE (111)
City	:	WILMINGTON
State	:	DE
Zip	:	19805-4917
Country	:	US
Telephone Number	:	302-633-5302
Fax Number	:	302-633-5582

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	07/08/2007

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