Individual
SUNIL K DWIVEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5223 HAMILTON WOLFE RD, SAN ANTONIO, TX 78229-4463
(210) 614-1234
(210) 614-0952
Mailing address
8415 DATAPOINT DR STE 700, SAN ANTONIO, TX 78229-3327
(210) 614-1234
(210) 614-0952
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M3528
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174532504
—
TX
01
—
8CJ470
BLUE CROSS BLUE SHIELD OF TEXAS
—
01
—
TXB105184
MEDICARE
TX
Enumeration date
06/03/2006
Last updated
03/17/2018
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