Provider Demographics
NPI:1316980485
Name:LIPTON, SUSAN V (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:V
Last Name:LIPTON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-5524
Mailing Address - Fax:410-601-8946
Practice Address - Street 1:5101 LANIER AVENUE
Practice Address - Street 2:SINAI HOSPITAL OF BALTIMORE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215
Practice Address - Country:US
Practice Address - Phone:410-601-9300
Practice Address - Fax:410-601-9499
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-08-31
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Provider Licenses
StateLicense IDTaxonomies
MDD52709208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD126903800Medicaid
MDE79538Medicare UPIN