Provider Demographics
NPI:1730150459
Name:HYPPOLITE, JEAN-CLAUDE (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN-CLAUDE
Middle Name:
Last Name:HYPPOLITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 DAVIE AVE
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-8256
Mailing Address - Country:US
Mailing Address - Phone:704-873-6515
Mailing Address - Fax:704-873-6508
Practice Address - Street 1:2603 DAVIE AVE
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-8256
Practice Address - Country:US
Practice Address - Phone:704-873-6515
Practice Address - Fax:704-873-6508
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9501284207RN0300X
NC95-01284207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8945170Medicaid
NC8945170Medicaid
NC2216069AMedicare ID - Type Unspecified