Provider Demographics
NPI:1871197285
Name:DIPPEL, ROBERT M III
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:DIPPEL
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16801 CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-4618
Mailing Address - Country:US
Mailing Address - Phone:440-543-7475
Mailing Address - Fax:
Practice Address - Street 1:16801 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4618
Practice Address - Country:US
Practice Address - Phone:440-543-7475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03230240183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist