Healthcare Provider Details

I. General information

NPI: 1871630228
Provider Name (Legal Business Name): RISHITA TIWARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 N FERGUSON AVE STE 104
TUCSON AZ
85712-2837
US

IV. Provider business mailing address

PO BOX 31235
TUCSON AZ
85751-1235
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-1010
  • Fax: 520-324-0029
Mailing address:
  • Phone: 520-324-4100
  • Fax: 520-324-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number56356
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: