Provider Demographics
NPI:1770146649
Name:TIWARI, MAHIMA (PT)
Entity type:Individual
Prefix:
First Name:MAHIMA
Middle Name:
Last Name:TIWARI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18042 COTTAGE GARDEN DR APT 301
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5832
Mailing Address - Country:US
Mailing Address - Phone:617-794-0357
Mailing Address - Fax:
Practice Address - Street 1:8380 COLESVILLE RD STE 270
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6255
Practice Address - Country:US
Practice Address - Phone:301-563-3081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27364225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD27364OtherMARYLAND BOARD OF PHYSICAL THERAPY EXAMINERS