Individual
MR. PHILLIP WILLIAM TOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
511 N HIGHWAY 52, MONCKS CORNER, SC 29461-3132
(843) 761-0936
(843) 761-0938
Mailing address
PO BOX 17190, LAS VEGAS, NV 89114-7190
(702) 560-2889
(702) 560-2928
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
103958
NC
363A00000X
Physician Assistant
Primary
1194
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0519PA
—
SC
01
—
P00834849
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
01/09/2007
Last updated
05/10/2011
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