Provider Demographics
NPI:1588805923
Name:PHIPPEN, NEIL THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:THOMAS
Last Name:PHIPPEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:6400 ARLINGTON BLVD STE 210
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2349
Practice Address - Country:US
Practice Address - Phone:703-531-3000
Practice Address - Fax:703-531-3142
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101255254207V00000X, 207VX0201X
MTMED-PHYS-LIC-69223207V00000X
TXR5454207VG0400X
IN01085672A207VX0201X
CODR.0063191207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300049872Medicaid