MEDICARE: PHILLIP STONE 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	207R00000X	Internal Medicine Physician	D0047009	MD

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0403181	OTHER	MD	EVERCARE
4	093NER-534556-02	OTHER		CAREFIRST BCBS OF MD
5	T016-0007	OTHER		BCBS-DC
6	53455602	OTHER	MD	BCBS
7	KGO1ER-534556-02	OTHER		CAREFIRST BCBS OF MD

General Provider Information

NPI Number	:	1154396679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP STONE MD

Provider Business Mailing Address
First Line	:	PO BOX 418
Second Line	:
City	:	LISBON
State	:	MD
Zip	:	21765-0418
Country	:	US
Telephone Number	:	410-442-6864
Fax Number	:

Provider Business Practice Location Address
First Line	:	16013 FIELDS END CT
Second Line	:
City	:	WOODBINE
State	:	MD
Zip	:	21797-7542
Country	:	US
Telephone Number	:	410-442-6864
Fax Number	:

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

Provider Enumeration Date	:	02/19/2006
Last Update Date	:	11/15/2022

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Directions to “ PHILLIP STONE MD” Practice Location

Language	Start Address	Practice Location

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