Individual
DR. BENJAMIN R. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 WALNUT ST, MOB, 5TH FLOOR, PHILADELPHIA, PA 19107-5563
(215) 955-6750
(215) 923-8222
Mailing address
1100 WALNUT ST, MOB, 5TH FLOOR, PHILADELPHIA, PA 19107-5563
(215) 955-6750
(215) 923-8222
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2005-01072
NC
208600000X
Surgery Physician
25MA08649700
NJ
208C00000X
Colon & Rectal Surgery Physician
MA08649700
NJ
208C00000X
Colon & Rectal Surgery Physician
Primary
MD433750
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901864
—
NC
01
—
MA08649700
STATE LICENSE
NJ
Enumeration date
10/28/2005
Last updated
12/14/2012
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