Provider Demographics
NPI:1780972372
Name:AGRAWAL, DEEKSHA (MD)
Entity type:Individual
Prefix:DR
First Name:DEEKSHA
Middle Name:
Last Name:AGRAWAL
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:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:614-544-6155
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:4343 ALL SEASONS DR
Practice Address - Street 2:STE 250
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1961
Practice Address - Country:US
Practice Address - Phone:614-788-3680
Practice Address - Fax:614-533-0217
Is Sole Proprietor?:No
Enumeration Date:2011-07-16
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT2001922084N0400X
OH35.1281772084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology