MEDICARE: ANITA ANN IYPE D.O.

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	2084P0800X	Psychiatry Physician	H84635	MD
2	2084P0800X	Psychiatry Physician	5101025538	MI

General Provider Information

NPI Number	:	1639598907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA ANN IYPE D.O.

Provider Business Mailing Address
First Line	:	6501 N CHARLES ST
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-6819
Country	:	US
Telephone Number	:	410-938-3461
Fax Number	:

Provider Business Practice Location Address
First Line	:	812 E JOLLY RD
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48910-6825
Country	:	US
Telephone Number	:	517-346-8200
Fax Number	:

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	01/24/2023

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Directions to “ ANITA ANN IYPE D.O.” Practice Location

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