Provider Demographics
NPI:1013367515
Name:THORP, ANDREW THOMAS JR (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:THOMAS
Last Name:THORP
Suffix:JR
Gender:M
Credentials:MD, MBA
Other - Prefix:
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Mailing Address - Street 1:6 BLACKSTONE VALLEY PL STE 105
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1112
Mailing Address - Country:US
Mailing Address - Phone:401-762-3838
Mailing Address - Fax:401-762-8252
Practice Address - Street 1:6 BLACKSTONE VALLEY PL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1179
Practice Address - Country:US
Practice Address - Phone:401-762-3838
Practice Address - Fax:401-762-8252
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD19366207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT070031Medicare PIN