Nisha Agarwal

Individual provider Active NPI Pediatric Critical Care Medicine Physician · Fargo, ND

NPI 1174928162 · NPPES record last updated Nov 24, 2020

Key facts

NPI
1174928162
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Critical Care Medicine Physician 2080P0203X
License
16699 (ND)
Practice address
5225 23Rd Ave S
Fargo, ND 58104-7927
Phone
(701) 417-2575
NPI assigned
Nov 3, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Critical Care Medicine Physician 2080P0203X 16699 ND Yes

Addresses

Primary practice location

5225 23Rd Ave S
Fargo, ND 58104-7927

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other providers in Fargo, ND

All providers in Fargo, ND · Pediatric Critical Care Medicine Physician in North Dakota

Sources for this page

Verify at the official NPI Registry.