Individual
VIVEK KUMAR AGRAWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 N BASCOM AVE STE 104, SAN JOSE, CA 95128-1811
(408) 918-0405
(408) 918-0409
Mailing address
13345 ILLINOIS ST, CARMEL, IN 46032-3318
(317) 396-1300
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
MD444582
PA
2085R0202X
Diagnostic Radiology Physician
01063473A
IN
2085R0202X
Diagnostic Radiology Physician
2006001569
MO
2085R0202X
Diagnostic Radiology Physician
246327
NY
2085R0202X
Diagnostic Radiology Physician
A98462
CA
2085R0202X
Diagnostic Radiology Physician
M9778
TX
2085R0202X
Diagnostic Radiology Physician
MD444582
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050546300
—
MD
05
—
102672800
—
PA
01
—
1605144
GATEWAY
PA
05
—
195353101
—
TX
01
—
2682453
HIGHMARK BLUE SHIELD
PA
05
—
300086932
—
IN
01
—
30113205
AMERIHEALTH MERCY - WMG
PA
01
—
765419
UPMC
PA
Enumeration date
09/01/2006
Last updated
07/02/2025
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