Basic Information
| Provider Information | |||||||||
| NPI: | 1154854396 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | TIWARI | ||||||||
| FirstName: | DIANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 49 JESSE HILL JR DR SE | ||||||||
| Address2: | #480A | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303033049 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 49 JESSE HILL JR DR SE | ||||||||
| Address2: | #480A | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303033049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042518796 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2017 | ||||||||
| LastUpdateDate: | 08/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 009321 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207L00000X | ME153996 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.