Provider Demographics
NPI:1336170703
Name:AGARWAL, AJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:AJAY
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5839 STONE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-6064
Mailing Address - Country:US
Mailing Address - Phone:937-268-6511
Mailing Address - Fax:937-267-3915
Practice Address - Street 1:4100 W 3RD ST
Practice Address - Street 2:CARDIOLOGY SECTION (111B)
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428-9000
Practice Address - Country:US
Practice Address - Phone:937-262-2113
Practice Address - Fax:937-267-3915
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.086217207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease