Provider Demographics
NPI:1720038300
Name:AGGARWAL, KUL B (MD)
Entity Type:Individual
Prefix:
First Name:KUL
Middle Name:B
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:PO BOX 7687
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65205-7687
Mailing Address - Country:US
Mailing Address - Phone:573-882-2259
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-2296
Practice Address - Fax:573-884-7743
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD100191207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO7204OtherBLUE CHOICE
KS2087052601OtherKANSAS MEDICAID
MO2504028OtherUNITED HEALTHCARE
MO272613OtherHEALTHLINK
IA527531OtherIOWA MEDICAID
MO7204OtherBLUE SHIELD
MO207972407Medicaid
MO7204OtherBLUE CHOICE
IA527531OtherIOWA MEDICAID
MO060032320Medicare PIN
MO2504028OtherUNITED HEALTHCARE
MOP00415499Medicare PIN