Individual
MR. EDWARD MICHAEL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
601 COLLIERS WAY, WEIRTON, WV 26062-5014
(304) 797-6000
Mailing address
123 JANE DR, WELLSBURG, WV 26070-2271
(304) 737-2716
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
58610
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2603370000
—
WV
Enumeration date
11/20/2006
Last updated
07/08/2007
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