Individual
KELLY M. MCPHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
29804 LAKE SHORE BLVD, WILLOWICK, OH 44095-4611
(440) 833-2095
(440) 833-2096
Mailing address
2500 METROHEALTH DR, CLEVELAND, OH 44109-1900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
57.029951
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0230630
—
OH
Enumeration date
04/25/2017
Last updated
03/08/2022
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