Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 234789 | MA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | LP00383 | RI |
NPI | 1083831374 |
---|---|
Provider Name | Brian Phillips |
First Address | Pittsfield, MA 01201-4109 |
Second Address | Pittsfield, MA 01201-4147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 05/06/2013 |