Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | IL |
NPI | 1316996580 |
---|---|
Provider Name | Dr. Anupam Agarwal |
First Address | Chesterfield, MO 63017-2474 |
Second Address | Saint Louis, MO 63125-4181 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 08/07/2007 |