Individual
SUMIT TIWARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 TERMINAL DR STE 4B, EAST ALTON, IL 62024-2296
(618) 216-8127
(618) 216-8128
Mailing address
2 TERMINAL DR STE 4B, EAST ALTON, IL 62024-2296
(618) 216-8127
(618) 216-8128
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12760
ND
207RC0000X
Cardiovascular Disease Physician
Primary
036153016
IL
207RC0000X
Cardiovascular Disease Physician
12760
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18920
—
ND
Enumeration date
08/31/2006
Last updated
05/01/2025
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