Healthcare Provider Details

I. General information

NPI: 1669653515
Provider Name (Legal Business Name): STEPHEN S. LIPPMAN, M.D., PH.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 03/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13538 EDGEMONT RD
SMITHSBURG MD
21783-1243
US

IV. Provider business mailing address

13538 EDGEMONT RD
SMITHSBURG MD
21783-1243
US

V. Phone/Fax

Practice location:
  • Phone: 301-992-6301
  • Fax:
Mailing address:
  • Phone: 301-992-6301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD0035547
License Number StateMD

VIII. Authorized Official

Name: DR. STEPHEN SAMUEL LIPPMAN
Title or Position: PRESIDENT
Credential: M.D., PH.D.
Phone: 301-992-6301