Individual
DR. ANGELA MICHELLE PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
407 E RUSSELL AVE BLDG C, WARRENSBURG, MO 64093-1242
(660) 747-5114
(660) 747-5684
Mailing address
407 E RUSSELL AVE BLDG C, WARRENSBURG, MO 64093-1242
(660) 747-5114
(660) 747-5684
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2001014668
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11127872
CAQH
MO
01
—
7664602
AETNA
MO
Enumeration date
07/24/2006
Last updated
07/09/2007
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