Healthcare Provider Details

I. General information

NPI: 1699905679
Provider Name (Legal Business Name): RACHNA TIWARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2009
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SCIENCE CT
MADISON WI
53711-1055
US

IV. Provider business mailing address

2500 OVERLOOK TER
MADISON WI
53705-2254
US

V. Phone/Fax

Practice location:
  • Phone: 608-284-6360
  • Fax:
Mailing address:
  • Phone: 608-256-1901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberMD60371242
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number64441-20
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT195296
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: