Provider Demographics
NPI:1902880503
Name:PHIPPS, MICHELE GIBBS (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:GIBBS
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:900 S IRBY ST
Mailing Address - Street 2:PMB 502
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5239
Mailing Address - Country:US
Mailing Address - Phone:843-674-5143
Mailing Address - Fax:843-674-5146
Practice Address - Street 1:805 PAMPLICO HWY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6047
Practice Address - Country:US
Practice Address - Phone:843-674-5143
Practice Address - Fax:843-674-5146
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC27494207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H11243Medicare UPIN