Individual
SUBODH K AGRAWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2005 PRINCE AVE, ATHENS, GA 30606-6032
(706) 208-9700
(706) 208-0806
Mailing address
2005 PRINCE AVE, ATHENS, GA 30606-6032
(706) 208-9700
(706) 208-0806
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
028344
GA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
028344
GA
208VP0000X
Pain Medicine Physician
028344
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00414554E
—
GA
01
—
060047315
RR MEDICARE
GA
Enumeration date
08/09/2005
Last updated
03/25/2026
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