MEDICARE: YASHWANT AGRAWAL MD

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	207RC0000X	Cardiovascular Disease Physician	62297	AZ
2	207RI0011X	Interventional Cardiology Physician	62297	AZ

General Provider Information

NPI Number	:	1063850709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASHWANT AGRAWAL MD

Provider Business Mailing Address
First Line	:	1960 W FRYE RD STE 5
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6238
Country	:	US
Telephone Number	:	480-917-5900
Fax Number	:	520-836-6661

Provider Business Practice Location Address
First Line	:	1960 W FRYE RD STE 5
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85224-6238
Country	:	US
Telephone Number	:	480-917-5900
Fax Number	:	520-836-6663

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

Provider Enumeration Date	:	06/04/2013
Last Update Date	:	07/09/2021

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Directions to “ YASHWANT AGRAWAL MD” Practice Location

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