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Individual
MR. MARK LUCAS PHILLIPS
Active
Individual
MR. MARK LUCAS PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
25639
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17619
PARTNERS
NC
01
—
2007829
UNITED HEALTHCARE
NC
01
—
371987800
USDOL
IL
01
—
5703760
VA MCD
VA
01
—
67625
BLUE CROSS BLUE SHIELD
NC
01
—
720000034
RR MEDICARE
NC
05
—
8967625
—
NC
01
—
99475
MEDCOST
NC
Enumeration date
01/04/2006
Last updated
03/30/2009
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