Provider Demographics
NPI:1144595414
Name:AGRAWAL, MUGDHA (MD)
Entity Type:Individual
Prefix:
First Name:MUGDHA
Middle Name:
Last Name:AGRAWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E EVESHAM RD STE 115
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4509
Mailing Address - Country:US
Mailing Address - Phone:856-424-5005
Mailing Address - Fax:212-731-5210
Practice Address - Street 1:2301 E EVESHAM RD STE 115
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4509
Practice Address - Country:US
Practice Address - Phone:856-424-5005
Practice Address - Fax:212-731-5210
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10843000207RR0500X
NY280684207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology