Individual
DR. ARCHANA MISHRA AGARWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15 MEDICAL DR, EMMA ECCLES JONES MEDICAL SCI, RM 2100, SALT LAKE CITY, UT 84112-1100
(801) 581-2507
Mailing address
2021 RIBBON LN, HOLLADAY, UT 84117-4323
(801) 414-1907
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Primary
5990116-1205
UT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
5990116-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00907158
RAILROAD MEDICARE PTAN
UT
Enumeration date
08/28/2008
Last updated
12/03/2021
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