Basic Information
| Provider Information | |||||||||
| NPI: | 1902840689 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGARWAL | ||||||||
| FirstName: | INDU | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.B., B.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| Address2: | 420 DELAWARE STREET SE, MMC 39 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126260644 | ||||||||
| FaxNumber: | 6126248176 | ||||||||
| Practice Location | |||||||||
| Address1: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| Address2: | 516 DELAWARE STREET SE, PWB FOURTH FLOOR, ROOM 4-100 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126266777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 31697 | MN | X | Allopathic & Osteopathic Physicians | Pediatrics | 2080N0001X | 31697 | MN | X | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0598698 | 05 | IA | MEDICAID | 47-04198 | 01 | MN | MEDICA PRIMARY | OTHER | B690 | 01 | MN | CHAMPUS/TRIWEST | OTHER | 0147866 | 01 | MT | MT MA | OTHER | 135375 | 01 | MN | UCARE | OTHER | 34823200 | 05 | WI | MEDICAID | 0896043 | 01 | MN | PREFERRED ONE | OTHER | 47-00229 | 01 | MN | MEDICA CHOICE | OTHER | HP15763 | 01 | MN | HEALTHPARTNERS | OTHER | 627T7AG | 01 | MN | BCBS | OTHER | 941916 | 01 | MN | ARAZ | OTHER |