Provider Demographics
NPI:1518931765
Name:PHILLIPS, WILLIAM B II (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:PHILLIPS
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:7501 GREENWAY CENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3514
Mailing Address - Country:US
Mailing Address - Phone:301-474-4679
Mailing Address - Fax:301-474-7182
Practice Address - Street 1:16901 MELFORD BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4443
Practice Address - Country:US
Practice Address - Phone:301-441-4577
Practice Address - Fax:301-220-0396
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-01-08
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Provider Licenses
StateLicense IDTaxonomies
MDD0048019207W00000X, 207WX0107X
DCMD20685207W00000X, 207WX0107X
VA0101215538207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC026873700Medicaid
VA006304435Medicaid
MD824610602Medicaid
VA006301991Medicaid
DC003417R87Medicare PIN
VA006301991Medicaid