Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 4301104667 | MI |
N | 207P00000X | Emergency Physician | MT200155 | PA |
N | 207QS0010X | Family Doctor - Sports Medicine | 4301104667 | MI |
NPI | 1013204205 |
---|---|
Provider Name | Kylee E Phillips |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2011 |
Last Update Date | 21/09/2015 |