Basic Information
Provider Information
NPI: 1952331944
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOPOULOS
FirstName: ARTHUR
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 51 NORTH 39TH STREET
Address2: 4 PHI
City: PHILADELPHIA
State: PA
PostalCode: 191042640
CountryCode: US
TelephoneNumber: 2156629189
FaxNumber: 2152434612
Practice Location
Address1: 51 NORTH 39TH STREET
Address2: 4 PHI
City: PHILADELPHIA
State: PA
PostalCode: 191042640
CountryCode: US
TelephoneNumber: 2156629189
FaxNumber: 2152434612
Other Information
ProviderEnumerationDate: 07/04/2006
LastUpdateDate: 02/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207UN0901XMD417551PAY Allopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology

ID Information
IDTypeStateIssuerDescription
001882800000205PA MEDICAID


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