Provider Demographics
NPI:1134202252
Name:RAMESH K. AGARWAL, M.D., P.A.
Entity type:Organization
Organization Name:RAMESH K. AGARWAL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-749-4999
Mailing Address - Street 1:145 E CARROLL ST
Mailing Address - Street 2:UNIT 103
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5454
Mailing Address - Country:US
Mailing Address - Phone:410-749-4999
Mailing Address - Fax:410-749-9300
Practice Address - Street 1:145 E CARROLL ST
Practice Address - Street 2:UNIT 103
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5454
Practice Address - Country:US
Practice Address - Phone:410-749-4999
Practice Address - Fax:410-749-9300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAMESH K AGARWAL MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-23
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054807174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD685500800Medicaid
MD170NMedicare PIN
MD685500800Medicaid