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General NPI Number Information
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NPI Number | 1831192335
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Entity Type | Individual
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Provider Name | STEVEN ELLIS LIPSON D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 6116 ROLLING RD STE 116
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1521
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Country | US
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Telephone | 703-893-6411
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Fax | 703-893-6415
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Provider Business Mailing Address
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Address Line | 6116 ROLLING RD STE116
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1521
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Country | US
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Telephone | 703-893-6411
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Fax | 703-893-6415
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0103000282
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License Number State | VA
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