Provider Demographics
NPI:1871976902
Name:DAPASH, THADEUS (DO)
Entity type:Individual
Prefix:
First Name:THADEUS
Middle Name:
Last Name:DAPASH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3426 TORINGDON WAY STE 108
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3497
Mailing Address - Country:US
Mailing Address - Phone:704-372-7974
Mailing Address - Fax:704-970-4746
Practice Address - Street 1:300 BILLINGSLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1180
Practice Address - Country:US
Practice Address - Phone:704-372-7974
Practice Address - Fax:704-372-8201
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2024-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102207068207RG0100X
NC2023-03307207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty