Individual
ANANDITA TIWARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
115 S PINE ST, CANYONVILLE, OR 97417-9648
(541) 839-4211
(541) 839-4983
Mailing address
PO BOX 888, CANYONVILLE, OR 97417-0888
(541) 839-4211
(541) 839-4983
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD26035
OR
291U00000X
Clinical Medical Laboratory
38D2107406
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027821
—
OR
Enumeration date
01/23/2006
Last updated
06/07/2022
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