Individual
GREGORY PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
337 S WHITE ST, WAKE FOREST, NC 27587-2916
(919) 554-0711
(919) 554-1185
Mailing address
337 S WHITE ST, WAKE FOREST, NC 27587-2916
(919) 554-0711
(919) 554-1185
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
442
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
442
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08099
BLUECROSS BLUESHIELD
NC
Enumeration date
10/16/2006
Last updated
04/24/2009
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