Healthcare Provider Details

I. General information

NPI: 1740213024
Provider Name (Legal Business Name): VICTOR M NIPPERT DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 KENNETT PIKE SUITE A-102
WILMINGTON DE
19807
US

IV. Provider business mailing address

685 UNIONVILLE RD
KENNETT SQUARE PA
19348
US

V. Phone/Fax

Practice location:
  • Phone: 302-652-5767
  • Fax: 302-652-4373
Mailing address:
  • Phone: 610-444-6520
  • Fax: 610-444-9571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE10000085
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC004005L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: