MEDICARE: DR. ERROL A PHILLIP 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	207Q00000X	Family Medicine Physician	D0009453	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100045	OTHER		AETNA HMO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4069881	OTHER		AETNA PPO
4	6531185	OTHER	MD	AETNA HMO
5	267081	OTHER		MAMSI
6	05256	OTHER		AMERIGROUP
7	147736500	OTHER		FEDERAL WORKMANS COMP
8	34655005	OTHER		BCBS
9	34655005	OTHER	MD	BCBS
10	0001	OTHER		BCBS
11	X602-0001	OTHER	DC	BCBS

General Provider Information

NPI Number	:	1831198829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERROL A PHILLIP MD

Provider Business Mailing Address
First Line	:	PO BOX 12622
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4017
Country	:	US
Telephone Number	:	443-481-6560
Fax Number	:	443-481-6515

Provider Business Practice Location Address
First Line	:	1419 FOREST DR
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21403-1482
Country	:	US
Telephone Number	:	410-990-0050
Fax Number	:	410-990-0336

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	08/24/2015

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Directions to “ DR. ERROL A PHILLIP MD” Practice Location

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