Individual
DR. VIVEK AGRAWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10511 GOLF COURSE RD NW STE 201, ALBUQUERQUE, NM 87114-5917
(505) 727-4430
(505) 727-9590
Mailing address
10511 GOLF COURSE RD NW STE 201, ALBUQUERQUE, NM 87114-5917
(505) 727-4430
(505) 727-9590
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01054190A
IN
207X00000X
Orthopaedic Surgery Physician
Primary
MD2020-0982
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90631846
—
NM
Enumeration date
07/31/2006
Last updated
01/29/2021
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