Provider Demographics
NPI:1164404620
Name:TIWARY, ANURAG D (MD)
Entity Type:Individual
Prefix:DR
First Name:ANURAG
Middle Name:D
Last Name:TIWARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10653 EARHART DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-5215
Mailing Address - Country:US
Mailing Address - Phone:727-346-6489
Mailing Address - Fax:
Practice Address - Street 1:14000 FIVAY RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7103
Practice Address - Country:US
Practice Address - Phone:727-861-0237
Practice Address - Fax:727-861-0278
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062882208600000X
NMMD2005-01362086S0127X
GA83687208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372631200Medicaid
P00747066OtherMEDICARE RAILROAD
P00747066OtherMEDICARE RAILROAD
FL372631200Medicaid
FL18762TMedicare PIN