Provider Demographics
NPI:1689791741
Name:TEWARI, ARPANA G (MD)
Entity Type:Individual
Prefix:DR
First Name:ARPANA
Middle Name:G
Last Name:TEWARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 W LARONA LN
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3959
Mailing Address - Country:US
Mailing Address - Phone:860-538-3532
Mailing Address - Fax:
Practice Address - Street 1:384 W LARONA LN
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-3959
Practice Address - Country:US
Practice Address - Phone:860-538-3532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40232207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ440138Medicaid
AZZ131209Medicare PIN
AZZ139627Medicare PIN