Provider Demographics
NPI:1861514689
Name:HYPOLITE, IMAN OLLIE (MD)
Entity type:Individual
Prefix:DR
First Name:IMAN
Middle Name:OLLIE
Last Name:HYPOLITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4938 HAMPDEN LN # 207
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2914
Mailing Address - Country:US
Mailing Address - Phone:240-401-9474
Mailing Address - Fax:240-491-5982
Practice Address - Street 1:5530 WISCONSIN AVE STE 802
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4462
Practice Address - Country:US
Practice Address - Phone:240-401-9474
Practice Address - Fax:240-491-5982
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00662022084P0804X, 2084P0800X
DCMD0384552084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry