Individual
DR. DAVID GLEN TIPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 815-5830
(910) 815-5698
Mailing address
PO BOX 602484, CHARLOTTE, NC 28260-2484
(910) 815-5830
(910) 815-5698
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200401588
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1380J
BCBS OF NC
NC
05
—
1497723886
—
NC
05
—
5900002
—
NC
01
—
E0541
MEDCOST
NC
05
—
Q0158K
—
SC
Enumeration date
03/10/2006
Last updated
04/28/2017
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