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:
Health care specialties
| Specialty | Code | License # | 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 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720042179 | NPPES |
| North Carolina | MEDICAID | 8912769 |
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