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General NPI Number Information
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NPI Number | 1003379595
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Entity Type | Individual
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Provider Name | ASHWINI TILAK MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2019
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 2220 N DRUID HILLS RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-3117
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Country | US
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Telephone | 404-785-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 770 P ST NW APT 618
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City | WASHINGTON
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State | DC
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Zip | 20001-3373
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Country | US
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Telephone | 904-463-2544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 26407
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number | 26407
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License Number State | DC
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