Provider Demographics
NPI:1598752610
Name:PHILIPS, MATTHEW FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:FRANK
Last Name:PHILIPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:STE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:480 HAWTHORN ST
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3729
Practice Address - Country:US
Practice Address - Phone:508-973-9150
Practice Address - Fax:508-973-9155
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2020-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA161120207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110062400AMedicaid
RIMP43358Medicaid
MA110062400AMedicaid
MA3026530Medicaid