Healthcare Provider Details

I. General information

NPI: 1710338660
Provider Name (Legal Business Name): SHVETA NANDINI TIWARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 E JEFFERSON ST STE B
CHARLOTTESVILLE VA
22902-5152
US

IV. Provider business mailing address

306 E JEFFERSON ST STE B
CHARLOTTESVILLE VA
22902-5152
US

V. Phone/Fax

Practice location:
  • Phone: 434-325-5053
  • Fax: 434-538-1136
Mailing address:
  • Phone: 434-325-5053
  • Fax: 434-538-1136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101268852
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number116029673
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: