Provider Demographics
NPI:1306978960
Name:AGARWAL, CORI ANN (MD)
Entity type:Individual
Prefix:DR
First Name:CORI
Middle Name:ANN
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CORI
Other - Middle Name:ANN
Other - Last Name:BUSCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:DIVISION OF PLASTIC SURGERY ADMINISTRATIVE OFFICE
Mailing Address - Street 2:30 NORTH 1900 EAST 3B205
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0001
Mailing Address - Country:US
Mailing Address - Phone:801-585-6839
Mailing Address - Fax:801-581-5794
Practice Address - Street 1:DIVISION OF PLASTIC SURGERY ADMINISTRATIVE OFFICE
Practice Address - Street 2:30 NORTH 1900 EAST 3B205
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-585-6839
Practice Address - Fax:801-581-5794
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93767208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery