Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 62297 | AZ |
Y | 207RI0011X | Interventional Cardiology | 62297 | AZ |
NPI | 1063850709 |
---|---|
Provider Name | Yashwant Agrawal |
First Address | Chandler, AZ 85224-6238 |
Second Address | Chandler, AZ 85224-6238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 09/07/2021 |