Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | D52709 | MD |
N | 2080P0208X | Pediatric Infectious Diseases | D52709 | MD |
NPI | 1316980485 |
---|---|
Provider Name | Susan V Lipton |
First Address | Baltimore, MD 21215-5216 |
Second Address | Baltimore, MD 21215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E79538 | (02) | MD |