Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | SC005525 | PA |
NPI | 1053349589 |
---|---|
Provider Name | Suzanne L. Phillips |
First Address | Richboro, PA 18954-1803 |
Second Address | Richboro, PA 18954-1803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 05/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1389267 | HIGH MARK BLUE SHIELD (01) | PA |
30080127 | KEYSTONE MERCY , INDIVIDUAL PROVIDER NUMBER (01) | PA |
U89990 | HEALTH PARTNERS (01) | PA |