Healthcare Provider Details

I. General information

NPI: 1811317027
Provider Name (Legal Business Name): ANTHONY TOPARIS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2014
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 MACCORKLE AVE SE
CHARLESTON WV
25304
US

IV. Provider business mailing address

78 PRESIDIO POINTE
CHARLESTON WV
25313-1537
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-4600
  • Fax: 304-388-4621
Mailing address:
  • Phone: 304-784-0585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3191
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: