Provider Demographics
NPI:1851472070
Name:GEORGE, PHILIP M (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:M
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 C SUNSET ROAD
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046
Mailing Address - Country:US
Mailing Address - Phone:609-877-0400
Mailing Address - Fax:609-877-1682
Practice Address - Street 1:218 C SUNSET ROAD
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046
Practice Address - Country:US
Practice Address - Phone:609-877-0400
Practice Address - Fax:856-877-1682
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA79408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3K2988OtherHEALTHNET
2673721000OtherAMERIHEALTH, KEYSTONE, IBC
010007760OtherAMERICHOICE
1079870OtherAETNA
2602159OtherUNITED HEALTHCARE
40760OtherUNIVERSITY HEALTHPLAN
8361556OtherCIGNA
P3632987OtherOXFORD
NJ0081779Medicaid
60020722OtherHORIZON NJ HEALTH
NJ095663 B67Medicare PIN
010007760OtherAMERICHOICE