Individual
DR. MARK DAVID PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
4924 CAMPBELL BLVD STE 200, BALTIMORE, MD 21236
(443) 442-2300
(410) 367-2035
Mailing address
9910 FRANKLIN SQUARE DR # 2110, BALTIMORE, MD 21236-4902
(410) 933-5412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D55495
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
699214500
—
MD
Enumeration date
09/08/2006
Last updated
06/05/2018
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