Individual
DR. CHARLES D PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
314 SE HOSPITAL AVE, STUART, FL 34994-2338
(772) 223-5903
(772) 223-5914
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-2832
(772) 223-5646
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0013388
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276747300
—
FL
01
—
43060
FL BLUE
FL
Enumeration date
07/13/2006
Last updated
06/03/2015
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