Individual
DR. PHILLIP F MAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1447 YORK RD STE 100, KAISER PERMANENTE TOWSON MEDICAL CENTER, LUTHERVILLE, MD 21093-6074
(410) 339-5500
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101230789
VA
207Q00000X
Family Medicine Physician
Primary
D0053902
MD
207Q00000X
Family Medicine Physician
MD039774
DC
Other
Enumeration date
12/01/2006
Last updated
12/06/2012
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