Individual
MICHAEL H PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5300 STATE ROAD 64, SUITE 101, GEORGETOWN, IN 47122-9178
(812) 923-4200
(812) 949-5966
Mailing address
3844 RELIABLE PKWY, CHICAGO, IL 60686-0001
(812) 949-5482
(812) 949-5966
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01047317A
IN
207R00000X
Internal Medicine Physician
31429
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200139960
—
IN
Enumeration date
04/19/2006
Last updated
06/04/2008
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