Provider Demographics
NPI:1669653515
Name:STEPHEN S. LIPPMAN, M.D., PH.D., P.A.
Entity Type:Organization
Organization Name:STEPHEN S. LIPPMAN, M.D., PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:LIPPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:301-992-6301
Mailing Address - Street 1:13538 EDGEMONT RD
Mailing Address - Street 2:
Mailing Address - City:SMITHSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21783-1243
Mailing Address - Country:US
Mailing Address - Phone:301-992-6301
Mailing Address - Fax:
Practice Address - Street 1:13538 EDGEMONT RD
Practice Address - Street 2:
Practice Address - City:SMITHSBURG
Practice Address - State:MD
Practice Address - Zip Code:21783-1243
Practice Address - Country:US
Practice Address - Phone:301-992-6301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035547207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD110240871OtherRAILROAD MEDICARE
MDP6224OtherINFORMED
MD419900600OtherMD MEDICAL ASSISTANCE
MD331MMedicare PIN
MD419900600OtherMD MEDICAL ASSISTANCE