Provider Demographics
NPI:1891922316
Name:AGARWAL, MONICA DEVI (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:DEVI
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 1:3949 BROWNING PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6536
Mailing Address - Country:US
Mailing Address - Phone:919-787-7411
Mailing Address - Fax:
Practice Address - Street 1:3949 BROWNING PL
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6536
Practice Address - Country:US
Practice Address - Phone:919-787-7411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD606375752085R0202X
MA2656462085R0202X
NC2022-008092085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0369626OtherL&I-RADA REST OF WA
WA0374562OtherL&I-SWEDISH RADIA EDMONDS
WA0374560OtherL&I-RADA KING CTY
WA0374563OtherL&I-EVERGREEN RADIA
WA2060007Medicaid
WAG8959957Medicare PIN
WAP01765934Medicare PIN
WAG8960111Medicare PIN