Ippolito, Mark Richard

Ippolito, Mark Richard is an individual health care provider with primary practice located at 200 Hawthorne Ln , Charlotte NC 28204-2515. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Ippolito, Mark Richard can be contacted via phone (704) 384-9437.

Contact Information

Primary practice address
200 Hawthorne Ln Charlotte NC 28204-2515
Phone: (704) 384-9437
Fax: (704) 384-9440
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sleep Medicine 2084S0012X 2000-00076 North Carolina
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 2000-00076 North Carolina

Profile Details

NPI number 1720042179
LBN Legal business name Ippolito, Mark Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Oct 25th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720042179 NPPES
North Carolina MEDICAID 8912769

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