Individual
DR. LARA PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1020 SANSOM ST, SUITE 239, PHILADELPHIA, PA 19107-5002
(215) 955-6844
(215) 955-2526
Mailing address
1020 SANSOM ST, SUITE 239, PHILADELPHIA, PA 19107-5002
(215) 955-6844
(215) 955-2526
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
257774
MA
207P00000X
Emergency Medicine Physician
MD0000049128
TN
207P00000X
Emergency Medicine Physician
Primary
MD453744
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0466581
—
NJ
05
—
103039208 0001
—
PA
05
—
103039208 0002
—
PA
Enumeration date
06/03/2011
Last updated
08/08/2017
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