Healthcare Provider Details

I. General information

NPI: 1467180109
Provider Name (Legal Business Name): APOORV TIWARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6245 INKSTER RD # GME
GARDEN CITY MI
48135-4001
US

IV. Provider business mailing address

6940 N INKSTER RD
DEARBORN HEIGHTS MI
48127-1881
US

V. Phone/Fax

Practice location:
  • Phone: 734-775-7152
  • Fax:
Mailing address:
  • Phone: 313-759-1643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4351050367
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: