Healthcare Provider Details

I. General information

NPI: 1164404620
Provider Name (Legal Business Name): ANURAG D TIWARY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 FIVAY RD
HUDSON FL
34667-7103
US

IV. Provider business mailing address

10653 EARHART DR
NEW PORT RICHEY FL
34654-5215
US

V. Phone/Fax

Practice location:
  • Phone: 727-861-0237
  • Fax: 727-861-0278
Mailing address:
  • Phone: 727-346-6489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME0062882
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberMD2005-0136
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number83687
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: