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MINTA ELIZABETH PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1317 N ELM ST, SUITE 1B, GREENSBORO, NC 27401-1023
(336) 274-9617
(336) 482-2177
Mailing address
1317 N ELM STREET, SUITE 1B, GREENSBORO, NC 27401-1023
(336) 274-9617
(336) 482-2177

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34128
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1600768
UNITED HEALTHCARE
NC
01
24728
PARTNERS
NC
01
300085688
RAILROAD MEDICARE
NC
01
67664
BLUE CROSS BLUE SHIELD
NC
01
73484
MEDCOST
NC
05
8967664
NC
Enumeration date
12/01/2005
Last updated
08/10/2012
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