Individual
RUCHIR AGRAWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 GENEVIEVE CT, PEACHTREE CITY, GA 30269
(678) 400-6650
(678) 669-2401
Mailing address
115 GENEVIEVE CT, PEACHTREE CITY, GA 30269
(678) 400-6650
(678) 669-2401
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
43561
WI
208000000X
Pediatrics Physician
43561
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003130521D&E
—
GA
05
—
34123200
—
WI
Enumeration date
10/05/2006
Last updated
07/21/2022
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