Healthcare Provider Details

I. General information

NPI: 1265417596
Provider Name (Legal Business Name): ALLISON SENTELLE LIPSEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 04/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 VERDAE BLVD STE A
GREENVILLE SC
29607-4032
US

IV. Provider business mailing address

1 INDEPENDENCE PT STE 212
GREENVILLE SC
29615-4536
US

V. Phone/Fax

Practice location:
  • Phone: 864-242-4683
  • Fax: 864-240-5028
Mailing address:
  • Phone: 864-797-6044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number15544
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: