Provider Demographics
NPI:1922092352
Name:LIPHAM, HARRY G (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:G
Last Name:LIPHAM
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 1:600 HOSPITAL DR STE 9
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8046
Mailing Address - Country:US
Mailing Address - Phone:828-452-0331
Mailing Address - Fax:828-456-6100
Practice Address - Street 1:600 HOSPITAL DR
Practice Address - Street 2:STE 9
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8024
Practice Address - Country:US
Practice Address - Phone:828-452-0331
Practice Address - Fax:828-456-8726
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25048207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8952099Medicaid
NC52099OtherBLUE CROSS
0470728OtherUNITED HEALTHCARE
NC52099OtherBLUE CROSS
C85168Medicare UPIN