Individual
DR. MATTHEW W PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
340 OXFORD STREET, SUITE 220, DOVER, OH 44622-1967
(330) 364-8011
(330) 364-0058
Mailing address
340 OXFORD STREET, SUITE 220, DOVER, OH 44622-1967
(330) 364-8011
(330) 364-0058
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35-052082
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000139928
ANTHEM
OH
01
—
020042125
RR MEDICARE
OH
01
—
0646330
AETNA
OH
05
—
0697938
—
OH
05
—
2080966
—
OH
01
—
341832667
STANDARD TAX ID
OH
01
—
341832667A
AULTCARE
OH
01
—
I700421
UNITED HEALTHCARE IND
OH
01
—
I7880
RR GROUP
OH
Enumeration date
08/03/2006
Last updated
02/13/2012
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