Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 4301104109 | MI |
NPI | 1003064825 |
---|---|
Provider Name | Dr. Cherie Renee Phillips |
First Address | Chesterland, OH 44026-2447 |
Second Address | Parma, OH 44129-5464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2008 |
Last Update Date | 01/12/2020 |