Provider Demographics
NPI:1023007176
Name:AGGARWAL, KEWAL K (MD)
Entity Type:Individual
Prefix:DR
First Name:KEWAL
Middle Name:K
Last Name:AGGARWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1878
Mailing Address - Country:US
Mailing Address - Phone:248-651-8200
Mailing Address - Fax:248-651-9546
Practice Address - Street 1:1100 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1878
Practice Address - Country:US
Practice Address - Phone:248-651-8200
Practice Address - Fax:248-651-9546
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301032882207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
B44541Medicare UPIN
OM08720Medicare ID - Type Unspecified