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Individual

MARK T PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
8700 SUDLEY ROAD, PRINCE WILLIAM HOSPITAL, MANASSAS, VA 20110
(703) 369-8337
(703) 369-8868
Mailing address
20010 CENTURY BLOULEVARD, SUITE 200, GERMANTOWN, MD 20874-1106
(240) 686-2300
(240) 686-2303

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001989
VA

Other

Enumeration date
07/26/2006
Last updated
11/03/2010
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