Healthcare Provider Details

I. General information

NPI: 1124245162
Provider Name (Legal Business Name): MANISH THAPAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 S 10TH ST 480 MAIN BUILDING
PHILADELPHIA PA
19107-5244
US

IV. Provider business mailing address

132 S 10TH ST 480 MAIN BUILDING
PHILADELPHIA PA
19107-5244
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-8900
  • Fax: 215-955-5245
Mailing address:
  • Phone: 215-955-8900
  • Fax: 215-955-5245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2007015934
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD424972
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number25MA07926400
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number25MA07926400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: