Provider Demographics
NPI:1679775886
Name:AGARWAL, RAKESH (MD)
Entity type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1601 KIRKWOOD HWY
Mailing Address - Street 2:PRIMARY CARE CBOC
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-4917
Mailing Address - Country:US
Mailing Address - Phone:800-461-8262
Mailing Address - Fax:856-794-2760
Practice Address - Street 1:1601 KIRKWOOD HWY
Practice Address - Street 2:PRIMARY CARE CBOC
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4917
Practice Address - Country:US
Practice Address - Phone:800-461-8262
Practice Address - Fax:856-794-2760
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY25MA07760800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine