Individual
DR. DAVID MILLARD PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
286 STAGE RD, CHARLTON, NY 12019-2619
(518) 399-2101
(518) 399-2130
Mailing address
286 STAGE RD, CHARLTON, NY 12019-2619
(518) 399-2101
(518) 399-2130
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
149839
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000401067002
BSNENY
NY
05
—
00715540
—
NY
01
—
070516000112
FIDELIS
NY
01
—
10001608
CDPHP
NY
01
—
11111
MVP
NY
01
—
200270
SENIOR WHOLE HEALTH
NY
01
—
28N101
EMPIRE BC
NY
01
—
47349
GHI/HMO
NY
01
—
5546684
AETNA
NY
Enumeration date
07/19/2006
Last updated
04/16/2010
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