1023026036 NPI number — DR. ANJULA AGRAWAL MD

Table of content: DR. ANJULA AGRAWAL MD (NPI 1023026036)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023026036 NPI number — DR. ANJULA AGRAWAL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AGRAWAL
Provider First Name:
ANJULA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023026036
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5000 MACARTHUR CT NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20016-3343
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-362-4494
Provider Business Mailing Address Fax Number:
202-362-4494

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5215 LOUGHBORO RD NW
Provider Second Line Business Practice Location Address:
SUITE 530
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20016-2618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-895-0050
Provider Business Practice Location Address Fax Number:
202-895-0051
Provider Enumeration Date:
08/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MP21871 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 54360003 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 58624632321501 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".