Individual
DR. ASHEESH TEWARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25230 MICHIGAN AVE, DEARBORN, MI 48124-1715
(134) 412-2273
(313) 441-2241
Mailing address
25230 MICHIGAN AVE, DEARBORN, MI 48124-1715
(313) 441-2227
(313) 441-2241
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2005008376
MO
207W00000X
Ophthalmology Physician
4301078018
MI
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
4301078018
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199360
MO-BLUE SHIELD
—
Enumeration date
06/29/2006
Last updated
06/23/2021
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