Individual
LEWIS EVERETT PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
336 MOUNT HOPE AVE, STE 11, BANGOR, ME 04401-4236
(207) 947-0128
(207) 947-0205
Mailing address
336 MOUNT HOPE AVE, STE 11, BANGOR, ME 04401-4236
(207) 947-0128
(207) 947-0205
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6085
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003955
ANTHEM
ME
01
—
111132712
RAILROAD MEDICARE
—
05
—
304680099
—
ME
Enumeration date
09/06/2005
Last updated
11/30/2009
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