Individual
DR. MAXIE LOGAN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
167 ASHLEY AVE, CHARLESTON, SC 29425-8905
(843) 792-4316
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
39352
SC
Other
Enumeration date
06/13/2016
Last updated
08/31/2020
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