Provider Demographics
NPI:1073682399
Name:WERNER, PHILIP MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:MICHAEL
Last Name:WERNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:310 MADISON AVENUE
Mailing Address - Street 2:STE 220
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-538-2055
Mailing Address - Fax:973-540-8849
Practice Address - Street 1:310 MADISON AVENUE
Practice Address - Street 2:STE 220
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-538-2055
Practice Address - Fax:973-540-8849
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0248752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WE453621Medicare ID - Type Unspecified
D19790Medicare UPIN