Organization
AJIT D. TIWARI, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AJIT DINESH TIWARI O.D. (OWNER)
(804) 732-5481
Entity
Organization
Contact information
Practice address
300 S SYCAMORE ST, PETERSBURG, VA 23803-5041
(804) 732-5481
Mailing address
300 S SYCAMORE ST, PETERSBURG, VA 23803-5041
(804) 732-5481
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000571
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009236210
—
VA
05
—
1053319293
—
VA
05
—
1427222603
—
VA
01
—
410040945
MEDICARE RAILROAD
VA
01
—
DN3306
MEDICARE RAILROAD
VA
Enumeration date
04/17/2008
Last updated
09/18/2010
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