Provider Demographics
NPI:1396740130
Name:LIPSHUTZ, HUGH (MD)
Entity type:Individual
Prefix:
First Name:HUGH
Middle Name:
Last Name:LIPSHUTZ
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 1:207 N. BROAD STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1500
Mailing Address - Country:US
Mailing Address - Phone:610-279-7696
Mailing Address - Fax:610-279-7782
Practice Address - Street 1:510 TOWNSHIP LINE RD STE 140
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2721
Practice Address - Country:US
Practice Address - Phone:610-279-7696
Practice Address - Fax:610-279-7782
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030121E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001041230018Medicaid
PA180219GT6Medicare PIN