Provider Demographics
NPI:1245432806
Name:AGRAWAL, PREETI (MD)
Entity Type:Individual
Prefix:
First Name:PREETI
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 1:1905 PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1933
Mailing Address - Country:US
Mailing Address - Phone:614-586-4159
Mailing Address - Fax:614-586-4252
Practice Address - Street 1:1905 PARSONS AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1933
Practice Address - Country:US
Practice Address - Phone:614-586-4159
Practice Address - Fax:614-586-4252
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35094688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3069236Medicaid
OH3069236Medicaid