Individual
MELODIE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3009 SMITH RD, FAIRLAWN, OH 44333-2666
(330) 665-4488
(330) 665-4489
Mailing address
3009 SMITH RD, FAIRLAWN, OH 44333-2666
(330) 665-4488
(330) 665-4489
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-052393P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000132182
ANTHEM
OH
05
—
0706230
—
OH
01
—
110140131
RAILROAD MEDICARE
OH
01
—
492
SUMMACARE
OH
01
—
729763
BUCKEYE COMMUNITY HEALTH
OH
01
—
PH0653555
MEDICARE PTAN PH0653555
OH
Enumeration date
03/24/2006
Last updated
10/20/2020
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