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General NPI Number Information
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NPI Number | 1699230169
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Entity Type | Individual
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Provider Name | MR. SAJAL KUMAR TIWARY
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Gender | Male
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 06/15/2025
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Provider Practice Location Address
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Address Line | 1959 NE PACIFIC STREET BOX 356423
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City | SEATTLE
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State | WA
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Zip | 98195-1003
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Country | US
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Telephone | 206-598-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 660 S EUCLID AVE, CB 8121
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City | SAINT LOUIS
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State | MO
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Zip | 63110
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Country | US
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Telephone | 314-362-8074
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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 | 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 #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MDRE.ML.61674596
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 1699230169
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License Number State | MO
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