Individual
CLARISSA M PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1180 NEWFIELD AVE, STAMFORD, CT 06905-1409
(314) 888-5233
Mailing address
1180 NEWFIELD AVE, STAMFORD, CT 06905-1409
(314) 888-5233
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39647
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000546325
ANTHEM BLUE CROSS
KY
01
—
027299800
BLACK LUNG
—
01
—
P002770084
RAILROAD MEDICARE
—
Enumeration date
02/13/2006
Last updated
03/20/2023
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