Individual
LAURA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(410) 532-4700
Mailing address
PO BOX 64407, BALTIMORE, MD 21264-4407
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C00845
MD
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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