Provider Demographics
NPI:1932300241
Name:AGRAWAL, ARUN (MD)
Entity type:Individual
Prefix:
First Name:ARUN
Middle Name:
Last Name:AGRAWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:446 N READING RD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-9802
Practice Address - Country:US
Practice Address - Phone:717-738-4334
Practice Address - Fax:717-738-3289
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4834540207R00000X, 207RC0200X, 207RP1001X
MI4301089980207R00000X
IN01069031A207R00000X
TN65256207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01270937OtherRR MEDICARE
INP00948401OtherRAILROAD MEDICARE PTAN
IN201015700Medicaid
INP00948401OtherRAILROAD MEDICARE PTAN
ININ1663029Medicare PIN