Provider Demographics
NPI:1073721023
Name:LIPPER, CAROL ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANN
Last Name:LIPPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:240 SAINT PAUL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5126
Mailing Address - Country:US
Mailing Address - Phone:303-746-0110
Mailing Address - Fax:303-333-8474
Practice Address - Street 1:240 SAINT PAUL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5126
Practice Address - Country:US
Practice Address - Phone:303-746-0110
Practice Address - Fax:303-333-8474
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COCO24720170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD24502Medicare UPIN