Provider Demographics
NPI:1164497418
Name:AGRAWAL, KAREN K (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:K
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 1:10173 CHELTON WOOD
Mailing Address - Street 2:4330
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-6649
Mailing Address - Country:US
Mailing Address - Phone:614-569-9258
Mailing Address - Fax:
Practice Address - Street 1:10173 CHELTON WOOD
Practice Address - Street 2:4330
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-6649
Practice Address - Country:US
Practice Address - Phone:614-569-9258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235380207R00000X
OH35-077814208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010027705Medicaid
VA010027705Medicaid
H06302Medicare UPIN
022538S33Medicare UPIN