Provider Demographics
NPI:1124008123
Name:AGARWAL, SONALI (MD)
Entity Type:Individual
Prefix:
First Name:SONALI
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONALI
Other - Middle Name:
Other - Last Name:GARG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8860 NE 82ND TERRACE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158-1600
Mailing Address - Country:US
Mailing Address - Phone:816-437-8101
Mailing Address - Fax:
Practice Address - Street 1:8860 NE 82ND TERRACE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1600
Practice Address - Country:US
Practice Address - Phone:816-437-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005001568207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1124008123Medicaid
MO35468066OtherBKBSKC
MOP01086120OtherRR MC
MO1124008123Medicaid
MO701000145Medicare PIN