Healthcare Provider Details

I. General information

NPI: 1871666735
Provider Name (Legal Business Name): PIYUSH TIWARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 12/16/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 E GIBBON RIVER WAY
TUCSON AZ
85718-4763
US

IV. Provider business mailing address

934 E GIBBON RIVER WAY
TUCSON AZ
85718-4763
US

V. Phone/Fax

Practice location:
  • Phone: 520-955-3133
  • Fax:
Mailing address:
  • Phone: 520-955-3133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number34321
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number34321
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: