Individual
DR. MAMATHA K AGRAWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4551 NEW BERN AVE # A100, RALEIGH, NC 27610-1551
(984) 215-4960
(984) 215-4965
Mailing address
4551 NEW BERN AVE # A100, RALEIGH, NC 27610-1551
(984) 215-4950
(984) 215-4955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200000169
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010066307
RAILROAD MEDICARE
NC
01
—
0156615
UHC
NC
01
—
116335
AETNA HMO
NC
01
—
127VU
BCBS
NC
01
—
171525
WELLPATH
NC
01
—
228096
MAMSI
NC
01
—
7478171
AETNA PPO
NC
01
—
8443512
CIGNA
NC
05
—
89127VU
—
NC
01
—
B4846
MEDCOST
NC
Enumeration date
06/28/2006
Last updated
05/04/2021
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