Provider Demographics
NPI:1659667673
Name:AGRAWAL, KSHITIJKUMAR MURLIDHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:KSHITIJKUMAR
Middle Name:MURLIDHAR
Last Name:AGRAWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:846 MASSACHUSETTS AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4713
Mailing Address - Country:US
Mailing Address - Phone:617-779-6500
Mailing Address - Fax:
Practice Address - Street 1:736 CAMBRIDGE ST
Practice Address - Street 2:BONE AND JOINT CENTER
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2907
Practice Address - Country:US
Practice Address - Phone:617-789-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP78081207X00000X
MA253777207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery