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Individual

DR. DOROTHY H KURTZ PHELAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.P.M.

Contact information

Practice address
100 BROOKSBY VILLAGE DR, PEABODY, MA 01960-1438
(978) 536-7850
(978) 536-7851
Mailing address
5730 EXECUTIVE DR STE 230, CATONSVILLE, MD 21228-1762
(978) 536-7850
(978) 536-7851

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2374
MA
213E00000X
Podiatrist
POD1030
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03Y002802ME02
ANTHEM NH
NH
01
060678
ANTHEM
ME
01
1841270642
GROUP NPI#
ME
01
1851499768
INDIVIDUAL NPI #
ME
01
200148199
TAX ID #
ME
01
22010099
MAINECARE IND#
ME
Enumeration date
09/21/2006
Last updated
04/19/2023
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