Organization
GARY W PHELPS CRNA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY W PHELPS CRNA (PRESIDENT)
(301) 317-0020
Entity
Organization
Contact information
Practice address
1838 GREENTREE ROAD, #180, BALTO, MD 21208
(301) 317-0020
(301) 317-0028
Mailing address
10508 CHESHAM WAY, WOODSTOCK, MD 21163-0000
(301) 317-0020
(301) 317-0028
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R130008
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F942001
CAREFIRST DC
DC
01
—
NA95GW
CAREFIRST MD
MD
Enumeration date
02/04/2008
Last updated
02/04/2008
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