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NPI Code Detail

MEDICARE: THADEUS DAPASH D.O

MEDICARE: THADEUS DAPASH D.O
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician2023-03307NC
2207RG0100XGastroenterology Physician0102207068VA

General Provider Information

NPI Number : 1871976902
Entity Type Code : Individual
Provider Name (Legal Business Name) : THADEUS DAPASH D.O
Provider Business Mailing Address
First Line : 3426 TORINGDON WAY STE 108
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-3497
Country : US
Telephone Number : 704-372-7974
Fax Number : 704-970-4746
Provider Business Practice Location Address
First Line : 300 BILLINGSLEY RD STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-1180
Country : US
Telephone Number : 704-372-7974
Fax Number : 704-372-8201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2015
Last Update Date : 01/13/2026

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