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Individual
DR. PHILLIP W LANDES
Active
Individual
DR. PHILLIP W LANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
D0043013
MD
208100000X
Physical Medicine & Rehabilitation Physician
Primary
D0043013
MD
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
D0043013
MD
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
D0043013
MD
Other
Enumeration date
12/08/2005
Last updated
02/27/2011
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