Provider Demographics
NPI:1720433592
Name:TIWARI, NITIN
Entity Type:Individual
Prefix:
First Name:NITIN
Middle Name:
Last Name:TIWARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4439 STATE ROUTE 159 STE G50
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-7202
Mailing Address - Country:US
Mailing Address - Phone:740-779-8580
Mailing Address - Fax:740-779-8589
Practice Address - Street 1:4439 STATE ROUTE 159 STE G50
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-7202
Practice Address - Country:US
Practice Address - Phone:740-779-8580
Practice Address - Fax:740-779-8589
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.140263207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology