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Individual

DR. ROGER STEVE PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
625 W OLIVE AVE, SUITE 310, MERCED, CA 95348-2419
(209) 723-4551
(209) 723-0141
Mailing address
625 W OLIVE AVE, SUITE 310, MERCED, CA 95348-2419
(209) 723-4551
(209) 723-0141

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A35984
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
942553560
TAX IDENTIFICATION NUMBER
CA
05
LAB44024F
CA
Enumeration date
08/19/2005
Last updated
08/10/2009
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