Individual
MICHAEL GAINES PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, ACNP
Contact information
Practice address
27 CREEKVIEW CT, SAME, GREENVILLE, SC 29615-4800
(864) 627-4032
(864) 627-4035
Mailing address
27 CREEKVIEW COURT, SAME, GREENVILLE, SC 29615
(864) 627-4032
(864) 627-4035
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
730
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11854536
CAQH UNIVERSAL PROVIDER ID
—
Enumeration date
05/11/2006
Last updated
08/21/2009
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