Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | OT018338 | PA |
NPI | 1023511987 |
---|---|
Provider Name | David Phillips |
First Address | Harrisburg, PA 17109-5317 |
Second Address | Harrisburg, PA 17109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2018 |
Last Update Date | 13/07/2021 |