Individual
ABHISHEK AGARWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1703 S MERIDIAN, STE 305, PUYALLUP, WA 98371
(253) 841-3933
(253) 848-7970
Mailing address
1703 S MERIDIAN STE 305, PUYALLUP, WA 98371-7590
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E5097
AR
207RG0100X
Gastroenterology Physician
Primary
MD60647401
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2060137
—
WA
01
—
G000188100
GROUP PTAN(K)
WA
01
—
G001045700
GROUP PTAN(P)
WA
01
—
MD60647401
WA LICENSE
WA
Enumeration date
04/12/2007
Last updated
06/21/2019
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