Healthcare Provider Details

I. General information

NPI: 1083924724
Provider Name (Legal Business Name): TANVI TIWARI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TANVI VASHISHT MD

II. Dates (important events)

Enumeration Date: 10/15/2010
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11116 MEDICAL CAMPUS RD
HAGERSTOWN MD
21742
US

IV. Provider business mailing address

23033 WINGED ELM DR
CLARKSBURG MD
20871-4447
US

V. Phone/Fax

Practice location:
  • Phone: 301-790-8804
  • Fax:
Mailing address:
  • Phone: 617-596-3307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD81075
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: