Individual
KEVIN EDWARD PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2775 GODWIN BLVD, SUFFOLK, VA 23434-8037
(757) 539-0069
Mailing address
61 LOXLEY RD, PORTSMOUTH, VA 23702-1809
(757) 675-9405
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202219021
VA
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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