Provider Demographics
NPI:1700844248
Name:BIPPART, PETER E (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:E
Last Name:BIPPART
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 1:115 PARKWAY OFFICE CT STE 104
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7436
Mailing Address - Country:US
Mailing Address - Phone:919-851-3480
Mailing Address - Fax:919-342-0434
Practice Address - Street 1:115 PARKWAY OFFICE CT STE 104
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7436
Practice Address - Country:US
Practice Address - Phone:919-851-3480
Practice Address - Fax:919-342-0434
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-9293207V00000X
NC2021-01060207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010150032OtherREGENCE BLUE SHEILD
ID807104800Medicaid
ID267221OtherALTIUS OLD
ID313130OtherALTIUS
ID74948OtherBLUE CROSS OLD
ID76964OtherBLUE CROSS
IDP00321831Medicare PIN
ID267221OtherALTIUS OLD