Basic Information
| Provider Information | |||||||||
| NPI: | 1396914719 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AGARWAL | ||||||||
| FirstName: | NEETA | ||||||||
| MiddleName: | BHAVALKAR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6608 SUNSET LN | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462604167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172575893 | ||||||||
| FaxNumber: | 3172575893 | ||||||||
| Practice Location | |||||||||
| Address1: | 2732 W MICHIGAN ST | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462223750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175544600 | ||||||||
| FaxNumber: | 3175544617 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/29/2008 | ||||||||
| LastUpdateDate: | 01/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A90236 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.