MEDICARE: RADHIKA AGARWAL

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	2083P0901X	Public Health & General Preventive Medicine Physician	99567	GA
2	207Q00000X	Family Medicine Physician	99567	GA

General Provider Information

NPI Number	:	1861954034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RADHIKA AGARWAL

Provider Business Mailing Address
First Line	:	782 PEACHTREE ST NE APT 1216
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-1593
Country	:	US
Telephone Number	:	773-672-9790
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-4018
Country	:	US
Telephone Number	:	773-672-9790
Fax Number	:

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

Provider Enumeration Date	:	04/04/2019
Last Update Date	:	04/13/2026

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