MEDICARE: MR. STEPHEN W HIPP MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	284174	NC
2	207T00000X	Neurological Surgery Physician	28417	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	140002836	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	17773	OTHER	PARTNERS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	42599	OTHER	BCBS
5	4260496	OTHER	AETNA

General Provider Information

NPI Number	:	1447236187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN W HIPP MD

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	704-367-4800
Fax Number	:	704-316-3025

Provider Business Practice Location Address
First Line	:	2801 RANDOLPH RD
Second Line	:	SUITE 100
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-1047
Country	:	US
Telephone Number	:	704-367-4800
Fax Number	:	704-316-3025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	07/08/2013

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Directions to “ MR. STEPHEN W HIPP MD” Practice Location

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