Organization
GLAUCOMA CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJIT K TIWARI MD (OWNER)
(765) 281-1181
Entity
Organization
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
ANTHEM
—
05
—
100094420E
—
IN
01
—
666840
MEDICARE PTN
—
Enumeration date
11/10/2009
Last updated
09/08/2010
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