Provider Demographics
NPI:1124245162
Name:THAPAR, MANISH (MD)
Entity type:Individual
Prefix:
First Name:MANISH
Middle Name:
Last Name:THAPAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 S 10TH ST
Mailing Address - Street 2:480 MAIN BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5244
Mailing Address - Country:US
Mailing Address - Phone:215-955-8900
Mailing Address - Fax:215-955-5245
Practice Address - Street 1:132 S 10TH ST
Practice Address - Street 2:480 MAIN BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5244
Practice Address - Country:US
Practice Address - Phone:215-955-8900
Practice Address - Fax:215-955-5245
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007015934207RG0100X
PAMD424972207RG0100X
NJ25MA07926400207RI0008X, 207RT0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207218504Medicaid
MO207218504Medicaid
MOP00601082Medicare PIN
PA080998TA4Medicare PIN
MO152360496Medicare PIN
MO311111879Medicare PIN
MO311115236Medicare PIN