Provider Demographics
NPI: | 1174677462 |
---|---|
Name: | PIPELING, MATTHEW ROBERT (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | MATTHEW |
Middle Name: | ROBERT |
Last Name: | PIPELING |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 330 TRENT DR HANES HOUSE RM 122; DUMC 102352 |
Mailing Address - Street 2: | |
Mailing Address - City: | DURHAM |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27710-3236 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 919-684-6140 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 330 TRENT DR HANES HOUSE RM 122; DUMC 102352 |
Practice Address - Street 2: | |
Practice Address - City: | DURHAM |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27710-3236 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-684-6140 |
Practice Address - Fax: | 919-684-3067 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-01-23 |
Last Update Date: | 2021-08-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | D0066760 | 207RP1001X |
NC | 2018-01166 | 207RP1001X |
PA | MD444194 | 207RP1001X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MD | 415745100 | Medicaid | |
MD | 133734YRJ | Medicare PIN | |
MD | 133734YVB | Medicare PIN |