Individual
GAUTAM AGARWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.B.S.
Contact information
Practice address
1120 15TH ST, BA-4300, AUGUSTA, GA 30912-0004
(706) 721-3671
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 828-8401
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
47831
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
640145700
—
MN
Enumeration date
12/14/2005
Last updated
09/08/2020
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