Individual provider Active NPI

Barun Agarwalla, MBBS

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
National Provider Identifier
1104761030
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351056543 Issued in MI
Practice address
4201 St, Antonie Street
Uhc 2E
Detroit, MI 48201
Phone
(313) 745-7888
NPI assigned
Apr 20, 2026
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351056543 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4201 St, Antonie Street
Uhc 2E
Detroit, MI 48201

Mailing address

3909 Woodward Ave
Apt 201
Detroit, MI 48201
Phone (219) 239-0459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4351056543MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1104761030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 WOODWARD AVE",
            "address_2": "APT 201",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "219-239-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 ST, ANTONIE STREET",
            "address_2": "UHC 2E",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGARWALLA",
        "first_name": "BARUN",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351056543",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.