Provider Demographics
NPI:1346381688
Name:LIPPMAN, DAVID HARRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HARRIS
Last Name:LIPPMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:HARRIS
Other - Last Name:LIPPMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:296 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1119
Mailing Address - Country:US
Mailing Address - Phone:413-528-4948
Mailing Address - Fax:
Practice Address - Street 1:296 DIVISION ST
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1119
Practice Address - Country:US
Practice Address - Phone:413-528-4948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA45694208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA55718Medicare UPIN
MAIOG043Medicare ID - Type Unspecified