Provider Demographics
NPI:1437686037
Name:THAPA, BERAHT RAJA (DO)
Entity Type:Individual
Prefix:DR
First Name:BERAHT
Middle Name:RAJA
Last Name:THAPA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 S BURNETT RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-2663
Mailing Address - Country:US
Mailing Address - Phone:937-864-2742
Mailing Address - Fax:937-864-2775
Practice Address - Street 1:247 S BURNETT RD STE 210
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-2663
Practice Address - Country:US
Practice Address - Phone:937-864-2742
Practice Address - Fax:937-864-2775
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34014829207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program