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General NPI Number Information
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NPI Number | 1821382896
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Entity Type | Organization
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Legal Business Name | CAROL ANNE PHILLIPS, M.D., LLC
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 301 SAINT PAUL ST SUITE 812
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City | BALTIMORE
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State | MD
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Zip | 21202-2102
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Country | US
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Telephone | 410-332-9878
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Fax | 410-547-1805
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Provider Business Mailing Address
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Address Line | 301 SAINT PAUL ST SUITE 812
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City | BALTIMORE
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State | MD
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Zip | 21202-2102
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Country | US
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Telephone | 410-332-9878
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Fax | 410-547-1805
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CAROL PHILLIPS
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Credential | M.D.
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Telephone | 410-332-9878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0047752
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License Number State | MD
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