Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0401X | Family Doctor - Addiction Medicine | MD0068492 | MD |
N | 208200000X | Surgeon | MD0068492 | MD |
N | 208600000X | Surgeon | MD0068492 | MD |
N | 208200000X | Surgeon | MD036446 | MD |
N | 208600000X | Surgeon | MD036446 | MD |
Y | 208D00000X | General Practice Physician | MD0068492 | MD |
NPI | 1912145707 |
---|---|
Provider Name | Phillip Sherman Ragland |
First Address | Red Lion, PA 17356-9646 |
Second Address | Baltimore, MD 21229-5204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2009 |
Last Update Date | 15/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1912145707 | NPI (01) | MD |
963103 | CAREFIRST (01) | MD |