Individual
MR. GARY ROSS FENNEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7600 CARROLL AVE, WASHINGTON ADVENTIST HOSPITAL, TAKOMA PARK, MD 20912-6367
(301) 891-7600
(301) 891-6313
Mailing address
15714 THISTLEBRIDGE DR, ROCKVILLE, MD 20853-3226
(301) 924-5388
(301) 891-6313
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0000622
MD
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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