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Individual

EDWARD MICHAEL PHILLIPS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
125 NASHUA STREET, SPAULDING REHABILITATION HOSPITAL, BOSTON, MA 02114
(617) 573-2200
(617) 573-2209
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
81005
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
081005
TUFTS HEALTH PLAN
MA
05
3138640
MA
01
J31225
BCBS MA
MA
Enumeration date
01/20/2006
Last updated
07/08/2007
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