Individual
DR. CHARLES M PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
517 MOYE BLVD FL 3, ECU PHYSICIANS DERMATOLOGY, GREENVILLE, NC 27834-2849
(252) 744-3109
(252) 744-2096
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
(252) 744-3253
(252) 744-3194
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
30079
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67705
BCBS NC
NC
01
—
70010076
RAILROAD MEDICARE
NC
05
—
8967705
—
NC
Enumeration date
09/15/2005
Last updated
12/05/2011
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