Provider Demographics
NPI:1265412407
Name:DIPIPPA, S. MATTHEW (DC)
Entity type:Individual
Prefix:DR
First Name:S. MATTHEW
Middle Name:
Last Name:DIPIPPA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:662 NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-8338
Mailing Address - Country:US
Mailing Address - Phone:724-283-2424
Mailing Address - Fax:724-283-2440
Practice Address - Street 1:662 NEW CASTLE RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-8338
Practice Address - Country:US
Practice Address - Phone:724-283-2424
Practice Address - Fax:724-283-2440
Is Sole Proprietor?:No
Enumeration Date:2006-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 005744-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA508389OtherCIGNA
PA1648896OtherBCBS GROUP#
PA518922OtherBCBS
PADC4546OtherRR MEDICARE
PA3688506OtherAETNA
PA248577OtherHEALTH AMERICA
PAP00169766OtherRR MEDICARE PIN #
PA1648896OtherBCBS GROUP#
PA3688506OtherAETNA
PAP00169766OtherRR MEDICARE PIN #