Individual
DR. AJIT D TIWARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
300 S SYCAMORE ST, PETERSBURG, VA 23803-5041
(804) 732-5481
(804) 732-8675
Mailing address
300 S SYCAMORE ST, PETERSBURG, VA 23803-5041
(804) 732-5481
(804) 732-8675
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000571
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009233245
—
VA
01
—
3977120002
ADMINISTAR
VA
01
—
410040945
MEDICARE RAILROAD
VA
01
—
DN3306
MEDICARE RAILROAD
VA
Enumeration date
07/12/2005
Last updated
10/10/2011
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