Provider Demographics
NPI:1851393375
Name:AGARWAL, SUNITA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNITA
Middle Name:
Last Name:AGARWAL
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 1:1288 TALON RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440-4306
Mailing Address - Country:US
Mailing Address - Phone:937-657-7165
Mailing Address - Fax:937-848-3738
Practice Address - Street 1:545 METRO PL S STE 100
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5353
Practice Address - Country:US
Practice Address - Phone:415-671-2165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-38342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2077854Medicaid
OH2077854Medicaid
OHAG0864532Medicare PIN
OHBA5704172OtherDEA