MEDICARE: DR. ASHA 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	207R00000X	Internal Medicine Physician	050408	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407844939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHA AGARWAL M.D.

Provider Business Mailing Address
First Line	:	3170 KETTERING BLVD BLDG B
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1924
Country	:	US
Telephone Number	:	937-236-2155
Fax Number	:	937-262-7201

Provider Business Practice Location Address
First Line	:	6251 MIAMI VALLEY WAY STE 210
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-5253
Country	:	US
Telephone Number	:	937-236-2155
Fax Number	:	937-262-7201

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

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	08/05/2025

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