Healthcare Provider Details

I. General information

NPI: 1285951830
Provider Name (Legal Business Name): PIYUSH TIWARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2010
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 BISHOP ST 1102
HONOLULU HI
96813-3301
US

IV. Provider business mailing address

500 ALA MOANA BLVD 2200
HONOLULU HI
96813-4920
US

V. Phone/Fax

Practice location:
  • Phone: 808-425-7718
  • Fax: 888-369-9109
Mailing address:
  • Phone: 808-522-7500
  • Fax: 808-522-7561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD17505
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: