Individual
DR. MARIANA A PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 RIVERSIDE CIR, SUITE 300, ROANOKE, VA 24016-4962
(540) 581-0160
Mailing address
1 RIVERSIDE CIR, SUITE 300, ROANOKE, VA 24016-4962
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101235823
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010187306
—
VA
01
—
P00459778
MEDICARE RAILROAD
VA
Enumeration date
07/06/2006
Last updated
08/11/2011
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