Provider Demographics
NPI:1376552075
Name:AGGARWAL, SHIV KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIV
Middle Name:KUMAR
Last Name:AGGARWAL
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 1:5522 TROUBLE CREEK RD
Mailing Address - Street 2:STE 100
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-5171
Mailing Address - Country:US
Mailing Address - Phone:727-842-7088
Mailing Address - Fax:727-848-6731
Practice Address - Street 1:5522 TROUBLE CREEK RD
Practice Address - Street 2:STE 100
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-5171
Practice Address - Country:US
Practice Address - Phone:727-842-7088
Practice Address - Fax:727-848-6731
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0061805207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104185OtherAVMED
FL27496OtherWELLCARE
FL370969800Medicaid
FL110138830OtherRAILROAD MEDICARE
FL14914OtherBLUE CROSS BLUE SHIELD
FL4237256OtherAETNA
FL27496OtherWELLCARE
FLF25275Medicare UPIN