MEDICARE: EMILIA PHILLIPS 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	208800000X	Urology Physician	232514	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000995801	OTHER	MA	MEDICARE PTAN
2	340020219	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	45988	OTHER		GHI
5	1356593701	OTHER	MA	GROUP NPI
6	32150487207	OTHER		NATIONAL LETTER CARRIERS

General Provider Information

NPI Number	:	1235195058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILIA PHILLIPS MD

Provider Business Mailing Address
First Line	:	900 CUMMINGS CTR
Second Line	:	SUITE 304T
City	:	BEVERLY
State	:	MA
Zip	:	01915-6198
Country	:	US
Telephone Number	:	978-998-3154
Fax Number	:	978-998-3156

Provider Business Practice Location Address
First Line	:	900 CUMMINGS CTR
Second Line	:	SUITE 304T
City	:	BEVERLY
State	:	MA
Zip	:	01915-6198
Country	:	US
Telephone Number	:	978-998-3154
Fax Number	:	978-998-3156

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

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	10/12/2016

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Directions to “ EMILIA PHILLIPS MD” Practice Location

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