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General NPI Number Information
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NPI Number | 1447696059
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Entity Type | Individual
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Provider Name | DR. SEAN MCPHILLIPS
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Gender | Male
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 5734 AMBER CT
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City | WILLOUGHBY
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State | OH
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Zip | 44094-3062
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Country | US
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Telephone | 216-215-8377
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Fax |
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Provider Business Mailing Address
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Address Line | 5734 AMBER CT
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City | WILLOUGHBY
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State | OH
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Zip | 44094-3062
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Country | US
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Telephone | 216-215-8377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R73905
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License Number State | AZ
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