Individual
DIWAKER AGARWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1813 W HARVARD AVE, ROSEBURG, OR 97471-2752
(541) 673-4303
(541) 440-9739
Mailing address
PO BOX 1547, ROSEBURG, OR 97470-0361
(541) 464-5840
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD 24927
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022605
—
OR
Enumeration date
10/26/2005
Last updated
05/29/2009
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