Individual
AJIT KUMAR TIWARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3700 N EVERBROOK LN, MUNCIE, IN 47304-5269
(765) 281-1181
(765) 282-4768
Mailing address
3700 N EVERBROOK LN, MUNCIE, IN 47304-5269
(765) 281-1181
(765) 282-4768
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01039897A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000219038
BLUE CROSS & BLUE SHIELD
IN
01
—
036119147
STATE LICENSE
IL
05
—
100094420E
—
IN
01
—
10236450000
TRICARE
IN
01
—
180027935
RR MEDICARE
IN
Enumeration date
10/02/2006
Last updated
11/10/2009
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