Basic Information
Provider Information
NPI: 1518925965
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AGARWAL
FirstName: PARUL
MiddleName: DUREJA
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7974 UW HEALTH CT
Address2:  
City: MIDDLETON
State: WI
PostalCode: 535625531
CountryCode: US
TelephoneNumber: 6088295485
FaxNumber:  
Practice Location
Address1: 750 UNIVERSITY ROW
Address2:  
City: MADISON
State: WI
PostalCode: 537051311
CountryCode: US
TelephoneNumber: 6088295485
FaxNumber: 6082626048
Other Information
ProviderEnumerationDate: 05/03/2006
LastUpdateDate: 01/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X49409WIY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207RI0008X49409WIN Allopathic & Osteopathic PhysiciansInternal MedicineHepatology

No ID Information.


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