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Individual
MAL PHILLIP HOMAN
Active
Individual
MAL PHILLIP HOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
OS020457
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT018268
PROFESSIONAL LICENSE NUMBER
PA
Enumeration date
05/24/2018
Last updated
06/08/2023
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