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General NPI Number Information
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NPI Number | 1457926669
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Entity Type | Individual
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Provider Name | NISHANT RAJENDRA TIWARI M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 09/01/2024
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Provider Practice Location Address
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Address Line | 800 NE 10TH ST FL 6
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5418
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Country | US
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Telephone | 405-271-8001
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Fax | 405-271-3020
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Provider Business Mailing Address
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Address Line | LOYOLA MEDICINE MCNEAL HOSPITAL 3249 SOUTH OAK PARK AVE
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City | BERWYN
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State | IL
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Zip | 60402
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Country | US
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Telephone | 708-783-3401
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 43744
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License Number State | OK
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