Basic Information
| Provider Information | |||||||||
| NPI: | 1629445721 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGARWAL | ||||||||
| FirstName: | ANKUSH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 409 S 2ND ST STE 2F | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171041612 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4300 LONDONDERRY RD | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171095317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172318772 | ||||||||
| FaxNumber: | 7172318435 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2015 | ||||||||
| LastUpdateDate: | 10/29/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 27878 | WV | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | MD462604 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.