Individual
DR. EDUARDO PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28500 ORCHARD LAKE RD, SUITE 201, FARMINGTON HILLS, MI 48334-2936
(248) 865-2575
(248) 865-2590
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPT, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301032927
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121731
GREAT LAKES HEALTH PLAN
MI
01
—
123104
CARE CHOICES HMO PROV. #
MI
01
—
22188
HEALTH PLAN OF MICHIGAN
MI
05
—
4192657
—
MI
01
—
QMXPR0017577
MOLINA HEALTHCARE
MI
Enumeration date
02/15/2006
Last updated
05/24/2011
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