MEDICARE: DR. ARVIND K WADHWA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	168079	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629077391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARVIND K WADHWA MD

Provider Business Mailing Address
First Line	:	273 DIVISION ST
Second Line	:
City	:	N TONAWANDA
State	:	NY
Zip	:	14120-4631
Country	:	US
Telephone Number	:	716-693-3344
Fax Number	:	716-693-2448

Provider Business Practice Location Address
First Line	:	273 DIVISION ST
Second Line	:
City	:	N TONAWANDA
State	:	NY
Zip	:	14120-4631
Country	:	US
Telephone Number	:	716-693-3344
Fax Number	:	716-693-2448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	03/18/2008

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