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General NPI Number Information
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NPI Number | 1720035496
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Entity Type | Organization
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Legal Business Name | STEPHEN W. HIPP, M.D., P.A.
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 1718 E 4TH ST 607
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City | CHARLOTTE
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State | NC
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Zip | 28204-3260
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Country | US
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Telephone | 704-377-1663
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Fax | 704-377-8051
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Provider Business Mailing Address
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Address Line | 1718 E 4TH ST 607
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City | CHARLOTTE
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State | NC
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Zip | 28204-3260
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Country | US
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Telephone | 704-377-1663
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Fax | 704-377-8051
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ROSEMARY B THOMAS
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Credential |
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Telephone | 704-377-1663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 28417
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License Number State | NC
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