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Individual
PHILIP S SOLUM
Active
Individual
PHILIP S SOLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0583
SD
363A00000X
Physician Assistant
Primary
107907
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4993070
SD BLUE CROSS
SD
05
—
6827540
—
SD
Enumeration date
01/20/2006
Last updated
03/09/2022
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