Provider Demographics
NPI:1285926329
Name:TEWARI-WASHAM, ABHA (MD)
Entity type:Individual
Prefix:DR
First Name:ABHA
Middle Name:
Last Name:TEWARI-WASHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ABHA
Other - Middle Name:
Other - Last Name:TEWARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:655 AFRICA RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9808
Mailing Address - Country:US
Mailing Address - Phone:614-326-2672
Mailing Address - Fax:
Practice Address - Street 1:4885 OLENTANGY RIVER RD STE 1-10
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1953
Practice Address - Country:US
Practice Address - Phone:614-268-6555
Practice Address - Fax:614-457-5713
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.122492207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
JA401ZOtherMEDICARE PTAN
FL021364300Medicaid
JA401ZOtherMEDICARE PTAN