Individual
DEEPAK AGARWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1009
(217) 544-6464
Mailing address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-5324
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036155410
IL
207L00000X
Anesthesiology Physician
R-10818
IA
390200000X
Student in an Organized Health Care Education/Training Program
266879
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266879
BWH, CARDIAC SURGERY ICU
MA
Enumeration date
07/19/2016
Last updated
06/11/2021
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