MEDICARE: ATEIAT Z PHILIPS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	9600680	NC
2	103TF0000X	Family Psychologist	92	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700963964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATEIAT Z PHILIPS MD

Provider Business Mailing Address
First Line	:	1970 W ARLINGTON BLVD
Second Line	:	STE A
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5783
Country	:	US
Telephone Number	:	252-752-0300
Fax Number	:	252-439-5323

Provider Business Practice Location Address
First Line	:	1970 W ARLINGTON BLVD
Second Line	:	STE A
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5783
Country	:	US
Telephone Number	:	252-752-0300
Fax Number	:	252-439-5323

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/01/2010

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