Provider Demographics
NPI:1225441363
Name:LIPSKY, PETER ELLIS (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ELLIS
Last Name:LIPSKY
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 1:1545 LONDON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-8881
Mailing Address - Country:US
Mailing Address - Phone:434-293-6526
Mailing Address - Fax:434-296-7462
Practice Address - Street 1:1545 LONDON RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-8881
Practice Address - Country:US
Practice Address - Phone:434-293-6526
Practice Address - Fax:434-296-7462
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018059207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology