Individual
DR. DANIEL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
13330 EUREKA RD, SOUTHGATE, MI 48195-1310
(734) 285-2990
(734) 285-2712
Mailing address
13330 EUREKA RD, SOUTHGATE, MI 48195-1310
(734) 285-2990
(734) 285-2712
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003890
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3450071
—
MI
01
—
900H26664
BLUE CROSS
MI
Enumeration date
06/13/2005
Last updated
03/26/2009
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