Mary Kathleen K. Agarwala, MD

Individual provider Active NPI Anesthesiology Physician · Salt Lake City, UT

NPI 1699353201 · NPPES record last updated Aug 31, 2022

Key facts

NPI
1699353201
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
12994410-1205 (UT)
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 581-2121
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12994410-1205UTMDAnesthesiology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 12994410-1205 UT Yes

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0001

Mailing address

30 N 1900 E RM 3C444
Salt Lake City, UT 84132-0001
Phone (801) 581-3622

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Anesthesiology Physician in Utah

Sources for this page

Verify at the official NPI Registry.