Provider Demographics
NPI:1093184848
Name:PHILLIPS, BRIGIT YADANA HTOON (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIGIT
Middle Name:YADANA HTOON
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 S MANCHESTER ST APT 440
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2742
Mailing Address - Country:US
Mailing Address - Phone:410-200-5412
Mailing Address - Fax:
Practice Address - Street 1:5 BEL AIR SOUTH PKWY
Practice Address - Street 2:SUITE 1535
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015
Practice Address - Country:US
Practice Address - Phone:410-569-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05914363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical