Physician Compare National (NPI:1720147879)

HEALTHCARE PROVIDER: THOMAS VIRGIL TUPPER MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1720147879
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668501800
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100526000224
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TUPPER
	Individual professional last name
Provider First Name	THOMAS
	Individual professional first name
Provider Middle Name	VIRGIL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1976
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	333 W 51ST ST
	Group Practice or individual's line 1 address
City	NEW YORK
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	100196401
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2122465888
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y