Individual
GERALD R PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
39 E CHESTNUT HILL AVE, PHILADELPHIA, PA 19118-2728
(215) 248-5600
(215) 242-0160
Mailing address
6005 CRICKET RD, FLOURTOWN, PA 19031-1202
(215) 248-5600
(215) 242-0160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD018700E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007826030001
—
PA
Enumeration date
06/05/2006
Last updated
02/18/2011
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