Provider Demographics
NPI:1528147006
Name:LIPPERT, DAVID MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:LIPPERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:MICHAEL
Other - Last Name:LIPPERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1659 ROUTE 228
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5319
Mailing Address - Country:US
Mailing Address - Phone:724-776-9770
Mailing Address - Fax:724-776-0949
Practice Address - Street 1:1659 ROUTE 228
Practice Address - Street 2:SUITE 101
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-5319
Practice Address - Country:US
Practice Address - Phone:724-776-9770
Practice Address - Fax:724-776-0949
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009632111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022402410001Medicaid
PA139162Medicare PIN
PA139162Medicare PIN