Provider Demographics
NPI:1295836997
Name:AGRAWAL, MURLI M (MD)
Entity Type:Individual
Prefix:DR
First Name:MURLI
Middle Name:M
Last Name:AGRAWAL
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 1:1800 VETERANS BULV
Mailing Address - Street 2:V A MEDICAL CENTER
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-3000
Mailing Address - Country:US
Mailing Address - Phone:478-272-1210
Mailing Address - Fax:
Practice Address - Street 1:1800 VETERANS BULV
Practice Address - Street 2:V A MEDICAL CENTER
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3000
Practice Address - Country:US
Practice Address - Phone:478-272-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123000207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00937444Medicaid
NYB82728Medicare UPIN
NY00937444Medicaid